国际糖尿病与妊娠研究组标准对妊娠期糖尿病患者母婴结局的影响  

Impact of diagnostic criteria set up by international diabetes mellitus pregnancy research group on the outcome of maternal and infant pregnancy in gestational diabetes mellitus

作　　者：李利平[1] 姜宏卫[1] 庞秋霞[2] 宋白利[1] 付留俊[1] 常毅娜[1] 刘鹏[1] 孙宗立[3] 

机构地区：[1]河南科技大学第一附属医院内分泌科,洛阳471000 [2]河南科技大学第一附属医院产科,洛阳471000 [3]河南科技大学第一附属医院中心实验室,洛阳471000

出　　处：《中国糖尿病杂志》2016年第5期416-418,共3页Chinese Journal of Diabetes

基　　金：洛阳市科技攻关计划(1301070A-3)

摘　　要：目的评估国际糖尿病与妊娠研究组（IADPSG）标准对GDM患者母婴妊娠结局的影响。方法采用前瞻性干预研究,收集于我院建档并分娩的孕妇,24～28周行75 g OGTT。IADPSG标准诊断GDM,给予饮食或胰岛素治疗。分析母婴结局。结果共纳入孕妇1723例,符合IADPSG标准诊断GDM者（GDM组）466例,糖耐量正常妊娠者（GNGT组）1257名,胰岛素应用约占总人群的1.22%。两组剖宫产率、妊高症率、胎儿宫内窘迫率及顺产侧切率比较,差异无统计学意义（P〉0.05）。GDM组早产儿、巨大儿、低体重儿发生率高于GNGT组。新增和单胎首次分娩GDM者结局与GNGT组比较,差异无统计学意义（P〉0.05）,低体重儿发生率低于GNGT组（P〈0.05）。结论采用IADPSG标准可改善减少早产和低体重儿的发生。Objective To assess the impact of diagnostic criteria of gestational diabetes mellitus（GDM） set up by the international diabetes pregnancy research group（IADPSG） on maternal and infant outcomes.Methods Pregnant women from our hospital were enrolled in this prospective intervention study.OGTT was done during 24 to 28 gestational weeks.IADPSG criteria for diagnosis of GDM was applied.GDM patients were treated with dietary control or insulin.Perinatal outcomes in pregnant women and newborns were analyzed.Results A total of 1723 pregnant women were enrolled in this study and divided into two groups：GDM diagnosed by IADPSG criteria（GDM group,n= 466）,and gestational normal glucose tolerance（GNGT group,n = 1257）.1.22%of pregnant women were under insulin treatment.Cesarean section,pregnancy induced hypertension,fetal distress,and birth maternal episiotomy rate had no significant difference between the two groups（P〈0.05）.However,premature birth[189（15.0%） vs 40（8.6%）,P = 0.000],macrosomia[105（8.4%） vs 54（11.6%）,P = 0.039],low weight infant rate[171（13.6%） vs 105（8.4%）,P= 0.001]were significantly higher in GDM group than in GNGT group.Pregnancy outcomes were not significantly different between newly-increased GDM and singleton first pregnancy population and GNGT group（P〈0.05）,but low weight infant rate was lower in newly-increased GDM and singleton first pregnancy population than in GNGT group[20（7.8%） vs 17（13.6%）;10（5.2%） vs 59（11.3%）,P〈0.05].Conclusion IADPSG criteria for diagnosis of GDM can improve the outcomes of pregnant women and newborns,reduce the occurrence of premature and low birth weight infants.

关 键 词：糖尿病 妊娠 诊断标准 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]