OGTT单项升高的妊娠期糖尿病孕妇围产结局分析  

Analysis of pregnancy outcome in gestational diabetes mellitus women with one abnormal glucose value of OGTT

作　　者：周雨梅 周梦林[1] 陈丹青[1] Zhou Yumei;Zhou Menglin;Chen Danqing(Women's Hospital Zhejiang University School of Medicine,Hangzhou310000)

机构地区：[1]浙江大学医学院附属妇产科医院,杭州310000

出　　处：《现代妇产科进展》2021年第8期589-592,共4页Progress in Obstetrics and Gynecology

基　　金：浙江省科技厅基金。

摘　　要：目的:分析葡萄糖耐量试验(OGTT)单项升高妊娠期糖尿病(GDM)孕妇的围产结局,为GDM分级管理模式提供临床依据。方法:纳入2015年11月1日至2018年4月30日在浙江大学医学院附属妇产科医院定期产检的OGTT单项升高GDM孕妇2912例,空腹血糖升高者为空腹组,服糖后1h血糖升高者为1h组,服糖后2h血糖升高者为2h组。同期随机纳入1676例正常妊娠孕妇作为正常对照,比较四组间一般资料及围产结局。结果:OGTT单项升高GDM组的年龄及孕前体质量指数(BMI)均显著高于正常妊娠(NGT)组。空腹组初次剖宫产、巨大儿和大于胎龄儿(LGA)的发生率均显著高于NGT组、1h组及2h组。调整孕妇年龄、孕前BMI、孕期增重后logistic回归分析显示,空腹组初次剖宫产、巨大儿和LGA的发生风险分别是正常对照组的1.35倍(95%CI为1.04~1.76)、2.15倍(95%CI为1.49~3.09)及2.37倍(95%CI为1.76~3.18)。结论:OGTT单项升高的GDM孕妇中,应重点关注空腹血糖升高者,以改善GDM围产结局。Objective:To investigate the pregnancy outcomes in gestational diabetes mellitus(GDM)women with one abnormal glucose value of oral glucose tolerance test(OGTT).Methods:Clinical data from 2912 GDM women with one abnormal glucose value of OGTT were collected from November 1st,2015 to April 30st,2018 in Women's Hospital Zhejiang University School of Medicine.The patients with elevated fasting plasma glucose were in the fasting group.The patients with elevated 1-hour plasma glucose were in the 1-hour group.The patients with elevated 2-hour plasma glucose were in the 2-hour group.Meanwhile,1676 normal pregnant women were randomly included as normal controls.Pregnancy outcomes of the four groups were analyzed.Results:Age and pre-pregnancy body mass index(BMI)of the GDM women were significantly higher than those of the normal glucose tolerance(NGT)group.The incidences of first cesarean section,macrosomia and large for gestational age(LGA)of the fasting group were significantly higher than those in the NGT group,1-hour group and 2-hour group.After adjusting for age,pre-pregnancy BMI and weight gain during pregnancy,GDM with abnormal fasting plasma glucose was an independent risk factor for first cesarean section(OR 1.35,95%CI:1.04~1.76),macrosomia(OR 2.15,95%CI:1.49~3.09)and LGA(OR 2.37,95%CI:1.76~3.18).Conclusions:Among GDM women with one abnormal glucose value of OGTT,more attention should be paid to those with abnormal fasting plasma glucose to improve the pregnancy outcome.

关 键 词：妊娠期糖尿病 葡萄糖耐量试验 围产结局 

分 类 号：R714.256[医药卫生—妇产科学]