妊娠合并糖尿病与母婴不良结局的临床相关性分析  

Clinical correlation between pregnancy with diabetes mellitus and adverse outcomes of mothers and infants

作　　者：张艳[1] 许青[2] 曾丽娜[1] 陈珠梅 林正勇 黄群芳 杨红帆 Zhang Yan;Xu Qing;Zeng Lina;Chen Zhumei;Lin Zhengyong;Huang Qunfang;Yang Hongfan(Center of prenatal diagnosis,the affiliated hospital of Putian College,Putian,Fujian,351100,China;Gynaecology and obstetrics department,the affiliated hospital of Putian College,Putian,Fujian,351100,China;Putian University,Putian,Fujian,351100,China)

机构地区：[1]莆田学院附属医院产前诊断中心,福建莆田351100 [2]莆田学院附属医院妇产科,福建莆田351100 [3]莆田学院,福建莆田351100

出　　处：《齐齐哈尔医学院学报》2022年第12期1127-1130,共4页Journal of Qiqihar Medical University

基　　金：福建省中青年教师教育科研项目(JAT200536);莆田学院校内科研项目(2019099)。

摘　　要：目的 评估血糖水平与母婴不良结局的相关性,为减少妊娠合并糖尿病患者母婴不良结局的发生提供临床依据。方法 选择2016年1月—2020年12月在本院产检及分娩的孕妇1698例作为研究对象,按照血糖水平及血糖控制情况分为三组,血糖正常者856例为对照组,妊娠合并糖尿病患者分为血糖控制良好组674例和血糖控制欠佳组168例,血糖控制欠佳组再分为血糖稍高组137例和血糖极高组31例,对不同组的母婴不良结局进行分析比较。结果 血糖控制欠佳组的剖宫产、子痫前期、产后出血、胎膜早破、羊水污染、新生儿窒息、死胎死产、新生儿病理性黄疸、胎儿畸形、巨大儿、新生儿肺炎以及新生儿低血糖的发生率均高于其他两组,阴道分娩率低于其他两组,差异有统计学意义(P<0.05);血糖极高组的各项母婴不良结局更差,差异有统计学意义(P<0.05);血糖控制良好组与对照组比较,母婴结局无显著差异(P>0.05)。结论 妊娠合并糖尿病的母婴不良结局受患者本身血糖水平的影响明显,其影响程度和血糖控制情况显著相关。医护人员需要对产妇在孕期及围产期的血糖给予严格控制,从而避免母婴不良结局事件的发生。Objective To evaluate the correlation between glycemic level and maternal-infant adverse outcomes, so as to provide clinical evidence for reducing maternal-infant adverse outcomes in patients with gestational diabetes mellitus.Methods From January 2016 to December 2020, 1698 parturients received antenatal care and give birth in the hospital were enrolled as study objects, and according to the glycemic level and blood glucose control they were divided into three groups, including 856 healthy women in control group, the pregnancy women suffered with gestational diabetes mellitus were divided into good blood glucose control group(n=674) and poor blood glucose control group(n=168), further more, the women in poor blood glucose control group were divided into hyperglycemia group(n=137) and extremely hyperglycemia group(n=31). The maternal-infant adverse outcomes of the various groups were analyzed and compared.Results The incidence rate of cesarean section rate, preeclampsia, postpartum hemorrhage, premature rupture of membranes, amniotic fluid contamination and neonatal asphyxia, stillbirth, neonatal pathological jaundice, fetal malformation, macrosomia, neonatal pneumonia and neonatal hypoglycemia of the group with bad glycemic control were higher than those of other groups, those differences were statistically significant(P<0.05). The uneventful delivery rate of group with bad glycemic control was lower than that of other groups(P<0.05). Maternal-infant outcomes were worse in the extremely hyperglycemia group(P<0.05). There was no significant difference in maternal and infant outcomes between good blood glucose control group and control group(P>0.05).Conclusions The maternal-infant adverse outcomes of pregnancy with diabetes mellitus are significantly affected by glycaemia. The degree of influence is directly related to the glycemic controlling. Medical staff need to strictly control glycaemia during pregnancy and perinatal period, avoid the occurrence of maternal-infant adverse outcomes.

关 键 词：妊娠合并糖尿病 剖宫产 母婴结局 

分 类 号：R714.7[医药卫生—妇产科学]