探讨不同妊娠期糖尿病诊断标准对母婴结局的影响  

Investigation on the influence of different diagnostic criteria of gestational diabetes mellitus on the maternal-infant outcomes

作　　者：程萌[1] 杨悦[1] 郝静[1] 

机构地区：[1]民航总医院妇产科,北京100054

出　　处：《北京医学》2016年第2期118-121,共4页Beijing Medical Journal

摘　　要：目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)新诊断标准对改善母婴结局的意义。方法收集2010年9月至2014年8月在我院自愿建档、系统产检,并分娩的孕妇9 323例,采用不同诊断标准诊断分为研究组和对照组,统计GDM的发病率、胰岛素的使用率、GDM孕妇并发症及围生儿结局的差异,探讨不同诊断标准对妊娠及围生结局的影响。结果研究组较对照组GDM诊断率升高(14.7%vs.5.4%),剖宫产率下降(41.7%vs.47.7%)及产后出血率下降(12.4%vs.16.2%),巨大儿率下降(7.25%vs.13.29%),低出生体重儿率下降(0.42%vs.0.83%),差异均有统计学意义(P<0.05)。两组胰岛素使用率差异无统计学意义(4.5%vs.4.6%,P>0.05)。结论使用新诊断标准使GDM诊断率增加,未增加胰岛素的使用率及低出生体重儿的发生率,同时降低了剖宫产率、产后出血率及巨大儿发生率,改善了母婴的不良结局。Objective To investigate the significance of new diagnostic criteria of gestational diabetes mellitus（GDM） on the maternal-infant outcomes. Methods The clinical data of pregnant women who had routine prenatal examination and deliveries in our hospital from September 2010 to August 2014 were analyzed. These 9 323 pregnant women were divided into the study group and the control group according to different diagnostic criteria. They were studied in the incident of GDM, rate of insulin usage, complications in pregnant women and the difference of perinatal infant outcomes.Results The diagnostic rate of the study group was higher than the control group（14.7% vs. 5.4%）, but the incidence of cesarean section（41.7% vs. 47.7%）and postpartum hemorrhage was less than those（12.4% vs. 16.2%）in the control group as well as the incidence of macrosomia（7.25% vs. 13.29%）and LBWI（0.42% vs. 0.83%）. The difference between the two groupswas statistically significant（P〈0.05）. The rates of insulin usage between the two groups were not statistically significant（P〈0.05）. Conclusion The diagnosis GDM by new diagnostic criteria will neither cause higher rate of insulin usage nor higher LBWI rate, however, lower cesarean section rate, postpartum hemorrhage rate and macrosomia rate could be observed and material-infant outcomes are improved.

关 键 词：妊娠期糖尿病 诊断标准 母婴结局 

分 类 号：R714.256[医药卫生—妇产科学]