GDM孕妇孕中期下生殖道感染、糖代谢指标水平变化及增重速率的临床意义  

Impact of lower reproductive tract infections,changes in glucose metabolism levels,and weight gain rate on maternal and infant outcomes in GDM pregnant women in the second trimester of pregnancy

作　　者：程迪 李武珊 朱秋玲 高凤春 CHENG Di;LI Wu-shan;ZHU Qiu-ling(Department of Obstetrics and Gynecology,Shandong First Medical University Affiliated Jinan Maternal and Child Health Hospital,Jinan Shandong 250001,China)

机构地区：[1]山东第一医科大学附属济南妇幼保健院产科,山东济南250001

出　　处：《临床和实验医学杂志》2024年第4期413-417,共5页Journal of Clinical and Experimental Medicine

基　　金：2019年度山东省医药卫生科技发展计划项目(编号:2019WS069);2019年济南市卫生健康委员会科技计划项目(编号:2019-1-27)。

摘　　要：目的探讨妊娠期糖尿病(GDM)孕妇孕中期下生殖道感染、糖代谢指标及增重速率的临床意义。方法采用前瞻性研究方法,选取2022年1月至12月在山东第一医科大学附属济南妇幼保健院产检并分娩的GDM孕妇210例作为研究对象。观察GDM孕妇的母婴不良妊娠结局发生情况,分析发生和未发生母婴不良妊娠结局GDM孕妇的年龄、学历、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(LDL-C)和低密度脂蛋白胆固醇(HDL-C)、孕中期空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、Log胰岛素抵抗指数(HOMA-IR)、Log胰岛β细胞功能(HOMA-β)等糖代谢指标及下生殖道感染情况、增重速率的差异,总结GDM孕妇发生母婴不良妊娠结局的影响因素。结果210例GDM孕妇中发生母婴不良妊娠结局58例,纳入发生母婴不良妊娠结局组,未发生母婴不良妊娠结局的152例GDM孕妇纳入未发生母婴不良妊娠结局组。发生母婴不良妊娠结局组的FBG、HbA1c、FINS、Log HOMA-IR和增重速率分别为(6.12±0.82)mmol/L、(6.23±0.69)%、(14.43±2.28)μU/L、0.60±0.20和(0.51±0.20)kg/周,均明显高于未发生母婴不良妊娠结局组[(4.40±0.67)mmol/L、(5.42±0.80)%、(11.43±2.03)μU/L、0.37±0.15和(0.34±0.18)kg/周],而Log HOMA-β为2.06±0.73,明显低于未发生母婴不良妊娠结局组(2.41±0.89),差异均有统计学意义(P<0.05);发生母婴不良妊娠结局组伴有下生殖道感染比率为55.17%,明显高于未发生母婴不良妊娠结局组(13.16%),差异有统计学意义(P<0.05);两组下生殖道感染类型比较差异无统计学意义(P>0.05);行Logistic回归分析显示:FBG、Log HOMA-IR、增重速率和下生殖道感染是GDM孕妇发生母婴不良妊娠结局的影响因素(P<0.05)。结论下生殖道感染、增重速率、FBG以及Log HOMA-IR是GDM孕妇发生母婴不良妊娠结局的影响因素,临床应加以重视,及早干预以确保母婴健康。Objective To investigate the effects of lower genital tract infection,glucose metabolism and weight gain rate on maternal and infant outcomes in pregnant women with gestational diabetes mellitus(GDM) in the second trimester of pregnancy.Methods Prospective research methods was used and 210 pregnant women with GDM who were examined and delivered in Shandong First Medical University Affiliated Jinan Maternal and Child Health Hospital from January to December 2022 were selected as research subject.The occurrence of adverse pregnancy outcomes in GDM pregnant women were observed.The differences of age,education level,total cholesterol,triglycerides,high-density lipoprotein cholesterol(LDL-C),and low-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),glycated hemoglobin(HbA1c),fasting insulin(FINS),Log Homeostasis model assessment for insulin resistance(HOMA-IR),Log Homeostasis model assessmentβ-cell(HOMA-beta),and other glucose metabolic indexes in the second trimester,lower reproductive tract infection and weight gain rate in the with and without adverse pregnancy outcomes in GDM pregnant women were analyzed,and the influencing factors of adverse pregnancy outcomes in GDM women were summarized.Results Fifty-eight out of 210 GDM pregnant women with adverse pregnancy outcomes were selected as the adverse maternal and infant pregnancy outcomes group,while 152 GDM pregnant women without adverse pregnancy outcomes were selected as the without adverse maternal and infant pregnancy outcomes group.The FBG,HbA1c,fasting insulin(FINS),Log HOMA-IR,and weight gain rate in the adverse maternal and infant pregnancy outcomes group were(6.12±0.82) mmol/L,(6.23±0.69)%,(14.43±2.28) μU/L,0.60±0.20,and(0.51±0.20) kg/week,respectively,which were significantly higher than those in the without adverse maternal and infant pregnancy outcomes group [(4.40±0.67) mmol/L,(5.42±0.80)%,(11.43±2.03) μU/L,0.37±0.15 and(0.34±0.18) kg/week],while the Log HOMA-β was 2.06±0.73,which was significantly lower than those in the

关 键 词：妊娠期糖尿病 孕中期 下生殖道感染 糖代谢 增重速率 母婴结局 

分 类 号：R714.256[医药卫生—妇产科学]