GDM患者血糖与母体并发症及新生儿代谢性疾病不良妊娠结局相关性分析  

Correlation of blood glucose with adverse pregnancy outcomes of mothers with gestational diabetes mellitus and their newborns

作　　者：王德亮 巩瑞春 Wang Deliang;Gong Ruichun(Department of Obstetrics,Dezhou People’s Hospital,Dezhou 253000,China;Department of Obstetrics,Dezhou Maternal and Child Health Care Hospital,Dezhou 253000,China)

机构地区：[1]德州市人民医院产科,253000 [2]德州市妇幼保健院产科,253000

出　　处：《国际医药卫生导报》2020年第10期1381-1384,共4页International Medicine and Health Guidance News

摘　　要：目的探讨妊娠期糖尿病(GDM)患者血糖水平变化与母体及新生儿不良妊娠结局的关系。方法选取2017年1月至2019年1月在德州市人民医院治疗的GDM患者210例,给予血糖控制,在分娩前1周行持续性动态血糖监测,观察母体及新生儿不良妊娠结局发生情况。结果共有31例孕妇发生不良妊娠结局,发生率为14.76%(31/210);共有98例新生儿发生不良妊娠结局,发生率为46.67%(98/210);发生母体不良妊娠结局者分娩前1周平均血糖水平(MBG)、血糖水平标准差(SDBG)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)分别为(6.03±0.91)mmol/L、(1.43±0.32)mmol/L、(2.88±0.43)mmol/L、(1.48±0.32)mmol/L,均明显高于未发生不良妊娠结局者,差异均有统计学意义(均P<0.05);发生新生儿不良妊娠结局孕妇分娩前1周MBG、SDBG、MAGE、MODD分别为(5.98±0.97)mmol/L、(1.40±0.30)mmol/L、(2.80±0.49)mmol/L、(1.43±0.32)mmol/L,均明显高于未发生新生儿不良妊娠结局孕妇,差异均有统计学意义(均P<0.05);logistic回归分析结果显示,MBG、MAGE是GDM患者发生母体不良妊娠结局的影响因素(OR=1.365、1.347,均P<0.05);MBG、MAGE、MODD是GDM患者发生新生儿不良妊娠结局的影响因素(OR=1.380、1.369、1.347,均P<0.05)。结论GDM患者血糖波动情况对母体及新生儿不良妊娠结局有所影响,在临床上应给予重视。Objective To explore the correlation of blood glucose with adverse pregnancy outcomes of mothers with gestational diabetes mellitus(GDM)and their newborns.Methods 210 patients with GDM who were treated in Dezhou People’s Hospital from January,2017 to January,2019 were selected for blood glucose control.Continuous dynamic blood glucose monitoring was conducted on them one week before delivery.The adverse pregnancy outcomes of the mothers and their newborns were observed.Results 31 pregnant women had adverse pregnancy outcomes,with an incidence of 14.76%(31/210).98 newborns had adverse outcomes,with an incidence of 46.67%(98/210).The mean blood glucose level(MBG),standard deviation of blood glucose level(SDBG),mean amplitude of glycemicexcursions(MAGE),and mean of daily differences(MODD)in the first week before delivery in the women with adverse pregnancy outcomes were(6.03±0.91)mmol/L,(1.43±0.32)mmol/L,(2.88±0.43)mmol/L,and(1.48±0.32)mmol/L,which were significantly higher than those in the women without adverse pregnancy outcomes(all P<0.05).The MBG,SDBG,MAGE and MODD in the first week before delivery of the pregnant women with newborn adverse outcome were(5.98±0.97)mmol/L,(1.40±0.30)mmol/L,(2.80±0.49)mmol/L,and(1.43±0.32)mmol/L,which were significantly higher than those of the pregnant women without newborn adverse outcomes(all P<0.05).The results of logistic regression analysis showed that MBG and MAGE were the influencing factors of maternal adverse pregnancy outcomes in the GDM patients(OR=1.365 and 1.347;both P<0.05);and MBG,MAGE,and MODD were the influencing factors of newborn adverse pregnancy outcomes in the GDM patients(OR=1.380,1.369,and 1.347;all P<0.05).Conclusion The fluctuation of blood glucose in GDM patients has some influence on the adverse pregnancy outcomes of the mothers and their newborns,which should be paid more attention in clinical practice.

关 键 词：妊娠期糖尿病 血糖 母体 新生儿 不良妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]