孕前体重指数及孕期血糖水平对妊娠期糖尿病孕妇围产期结局的影响  

Effects of pre-pregnancy body mass index and blood glucose level on perinatal outcomes in pregnant women with gestational diabetes mellitus

作　　者：杨元元 杨盼 万瑞[1] Yang Yuanyuan;Yang Pan;Wan Rui(Department of Obstetrical,The Yellow River Sanmenxia Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]黄河三门峡医院产科,河南三门峡472000

出　　处：《感染、炎症、修复》2024年第3期218-221,共4页Infection Inflammation Repair

摘　　要：目的:探讨孕前体重指数(BMI)及孕期血糖水平对妊娠期糖尿病(GDM)孕妇围产期结局的影响。方法:选取2021年3月至2023年12月于黄河三门峡医院分娩的206例GDM孕妇,以孕前BMI为依据分为低BMI组(孕前BMI<18.5 kg/m2)、BMI正常组(18.5 kg/m2≤BMI<25.0 kg/m2)及超重肥胖组(BMI≥25.0 kg/m2),分别为23例、148例及35例;孕24~28周行葡萄糖耐量实验并记录血糖水平。记录各组孕妇及新生儿的妊娠结局。结果:空腹、服糖后1 h以及2 h血糖水平超重肥胖组>BMI正常组>低BMI组(P<0.05)。超重肥胖组孕妇剖宫产率和产后出血发生率明显高于其他两组(P<0.05)。超重肥胖组新生儿发生早产、巨大儿、新生儿低血糖、胎儿窘迫和新生儿窒息的比例明显高于低BMI组和BMI正常组(P<0.05)。根据血糖控制情况分组,控制不良组孕妇的剖宫产率和产后出血比例明显高于控制理想组和对照组(P<0.05)。控制不良组巨大儿、早产、胎儿窘迫、新生儿窒息及产后出血发生率较控制理想组、对照组更高(P<0.05);而控制理想组与对照组比较,差异无统计学意义(P>0.05)。结论:孕前BMI高可对孕妇孕期血糖产生影响,是GDM孕妇围产结局的影响因素之一;有效控制GDM孕妇的血糖水平,可减少孕妇与新生儿的并发症,改善母婴妊娠结局。Objective:To investigate the effect of pre-pregnancy body mass index(BMI)and blood glucose level during pregnancy on perinatal outcome of pregnant women with diabetes mellitus(GDM).Methods:A total of 206 pregnant women with gestational diabetes mellitus(GDM)who gave birth in the Yellow River Sanmenxia Hospital from March 2021 to December 2023 were selected and divided into three groups based on their pre-pregnancy BMI:the low BMI group(prepregnancy BMI<18.5 kg/m2),the normal group(18.5 kg/m2≤BMI<25.0 kg/m2),and the overweight and obese group(BMI≥25.0 kg/m2),which were 23 cases,148 cases,and 35 cases,respectively.The oral glucose tolerance test(OGTT)was performed from 24 to 28 weeks of pregnancy and blood glucose levels were recorded.Also,the pregnancy outcomes of pregnant women and newborns in each group were recorded.Results:The fasting,1-hour,and 2-hour blood glucose levels in the overweight and obese group were significantly higher than those in the low BMI group and the normal BMI group(P<0.05);The fasting,1-hour,and 2-hour blood glucose levels of pregnant women in the normal group were higher than those in the low BMI group(P<0.05).The cesarean section rate and postpartum hemorrhage rate of overweight and obese pregnant women were significantly higher than the other two groups(P<0.05).The proportion of premature birth,macrosomia,neonatal hypoglycemia,fetal distress,and neonatal asphyxia in the overweight and obese group was significantly higher than those in the low BMI group and normal BMI group(P<0.05).According to the blood glucose control status,the cesarean section rate and postpartum hemorrhage rate of poorly controlled pregnant women were significantly higher than those of the ideal control group and the control group(P<0.05).The incidence of macrosomia,premature birth,fetal distress,neonatal asphyxia,and postpartum hemorrhage in the poorly controlled group was higher than that in the ideal control group and the control group(P<0.05).According to the classification of blood glucose control,the rat

关 键 词：妊娠期糖尿病 血糖 葡萄糖耐量试验 体重指数 

分 类 号：R714[医药卫生—妇产科学] R587.1[医药卫生—临床医学]