妊娠糖尿病孕妇不同OGTT结果与妊娠结局及孕前BMI的关系研究  

Relationship between different OGTT results,pregnancy outcome and pre-pregnancy body mass index in gestational diabetes mellitus

作　　者：林曼[1] 许莉[1] 孙明霞[1] 张燕[1] 王秀妹[1] LIN Man;XU Li;SUN Mingxia;ZHANG Yan;WANG Xiumei(Department of Obstetrics,Haikou Hospital of Maternal and Child Health,Haikou,Hainan 570102,China)

机构地区：[1]海南省海口市妇幼保健院妇产科,570102

出　　处：《检验医学与临床》2018年第23期3533-3535,3538,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨妊娠糖尿病(GDM)孕妇不同葡萄糖耐量试验(OGTT)结果与妊娠结局及孕前体质量指数(BMI)的关系。方法选取2015年1月至2017年12月在该院行产前检查并住院分娩的4 898例孕妇作为研究对象。根据孕24～28周接受75g葡萄糖耐量试验(OGTT)结果分为GDMⅠ组(OGTT空腹血糖、OGTT 1h血糖或OGTT 2h血糖任意1个时点异常)、GDMⅡ组(任意2个时点血糖异常)和GDMⅢ组(3个时点血糖均异常),以及血糖正常组(3个时点血糖均正常)。对各组妊娠结局及孕前BMI进行分析。结果 GDM检出率为22.5%(1 102/4 898),其中,GDMⅠ组759例(68.88%)、GDMⅡ组204例(18.51%)、GDMⅢ组139例(12.61%)。GDM组孕妇的剖宫产率、早产率、巨大儿发生率、大于胎龄儿发生率、新生儿低血糖患病率、妊娠高血压患病率均明显高于血糖正常组,差异有统计学意义(P<0.05)。随着血糖异常指标的增多,剖宫产率、巨大儿发生率、大于胎龄儿发生率、新生儿低血糖患病率和胰岛素治疗率也呈上升趋势,差异有统计学意义(P<0.05)。轻体质量、正常体质量、超重和肥胖孕妇的GDM检出率分别为13.34%、20.72%、31.58%和39.18%,随着孕前BMI增加,GDM的检出率也明显增加(χ_(趋势)~2=110.175,P<0.001)。结论孕前BMI处于超重或肥胖,以及OGTT 3个时间点血糖异常的GDM孕妇其妊娠结局最差。Objective To investigate the relationship between different oral glucose tolerance test （OGTT）,pregnancy outcome and pre-pregnancy body mass index （BMI） in gestational diabetes mellitus （GDM）. Methods A total of 4 898 pregnant women who were received prenatal examination and delivered in Haikou Hospital of Maternal and Child Health between January,2015 and December,2017 were collected as objects.According to the results of 75 g OGTT at 24-28 gestational weeks,they were divided into 4 groups：GDM group Ⅰ（fasting OGTT blood glucose,OGTT 1 h blood glucose or OGTT 2 h blood glucose was abnormal at any time point）,GDM group Ⅱ（blood glucose was abnormal at any two time points）,GDM group Ⅲ（blood glucose was abnormal at three time points） and normal blood glucose group （blood glucose was normal at three time points）.The pregnancy outcome and pre-pregnancy BMI in each group were compared. Results The detection rate of GDM was 22.5% （1 102/4 898）,including GDM group Ⅰ 759 cases （68.88%）,GDM groupⅡ 204 cases （18.51%） and GDM group Ⅲ 139 cases （12.61%）.The rates of caesarean section,preterm birth rate,incidence of gigantic infant,incidence of fetal age,prevalence of hypoglycemia and pregnancy induced hypertension in group GDM were significantly higher than those in normal blood glucose group （ P 〈 0.05 ）.With the increase of abnormal glycemic items （fasting OGTT,OGTT 1 h,OGTT 2 h）,the rate of caesarean section,the incidence of giant infants,the incidence of gestational age,the prevalence of hypoglycemia and the rate of insulin treatment also increased,the differences were statistically significant （ P 〈 0.05 ）.The GDM detection rates of light body mass,normal body mass,overweight and obese pregnant women were 13.34 %,20.72%,31.58% and 39.18% respectively.With the increase of BMI before pregnancy,the detection rate of GDM increased significantly （ χ 2 trend =110.175, P 〈0.001）. Conclusion Pre-pregnancy BMI of GDM pregnant women who has overweight

关 键 词：妊娠糖尿病 葡萄糖耐量试验 体质量指数 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]