GDM患者产程血糖管理及血糖水平与不良妊娠结局的相关性  

Correlation between the blood glucose management during labor and the blood glucose level of pregnant women with gestational diabetes mellitus and their adverse pregnancy outcomes

作　　者：张媚靓 郑亚芹 崔岳崇 傅英钦 董璐 ZHANG Meiliang;ZHENG Yaqin;CUI Yuechong;FU Yingqin;DONG Lu(Yiwu Maternity and Children Health Care Hospital(Yiwu Women and Children Hospital Affiliated to Hangzhou Medical College),Yiwu,Zhejiang Province,322000)

机构地区：[1]浙江省义乌市妇幼保健院,杭州医学院附属义乌妇女儿童医院,322000

出　　处：《中国计划生育学杂志》2025年第1期203-207,共5页Chinese Journal of Family Planning

基　　金：浙江省教育厅一般科研项目(Y202146075)。

摘　　要：目的:分析妊娠期糖尿病(GDM)患者产程血糖管理及血糖水平与不良妊娠结局的相关性。方法:回顾性收集2022年1月-2023年6月本院自然分娩孕妇220例临床资料,根据妊娠期糖耐量检测结果分为GDM组(n=170)与糖耐量正常组(n=50),根据是否行产程血糖管理将GDM组分为未管理组(n=68)和管理组(n=102)。分别比较GDM组与糖耐量正常组、管理组与未管理组产程中血糖水平及不良妊娠结局发生情况,分析GDM患者产程血糖管理及血糖水平与不良妊娠结局的相关性。结果:GDM组血糖水平标准差(SDBG)、平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、日间血糖平均绝对差(MODD)均高于糖耐量正常组,不良妊娠结局发生率高于糖耐量正常组;管理组SDBG(1.28±0.17mmol/L)、MAGE(3.37±0.31mmol/L)、LAGE(4.02±0.55mmol/L)、MODD(0.72±0.11mmol/L)值低于未管理组(1.46±0.35mmol/L、3.81±0.42mmol/L、4.28±0.76mmol/L、0.85±0.13mmol/L),不良妊娠结局低于未管理组;GDM患者产程血糖管理与不良妊娠结局呈负相关(r=-0.439),产程中SDBG、MAGE、LAGE、MODD值与不良妊娠结局呈正相关(r=0.416、0.426、0.433、0.409)(均P<0.05)。结论:GDM患者行产程血糖管理有利于降低不良妊娠结局发生风险,且产程中血糖控制越好血糖值波动范围越小。Objective:To analyze the correlation between the blood glucose management during labor and the blood glucose level of pregnant women with gestational diabetes mellitus(GDM)and their adverse pregnancy outcomes.Methods:The clinical data of 220 pregnant women who gave birth in the hospital from January 2022 to June 2023 were collected retrospectively.According to the glucose tolerance test results of these women during pregnancy,these women were divided into study group(170 women with GDM)and control group(50 women with normal glucose tolerance during pregnancy),According to the implementation situation of the blood glucose management of the women in the study group during labor,the women were also divided into group A(68 women without the blood glucose management)and group B(102 women with the blood glucose management).The blood glucose level during labor and the adverse pregnancy outcomes of the women were compared between the study group and the control group and between group A and group B.The correlation between the blood glucose management during labor and the blood glucose level of the women with GDM and their adverse pregnancy outcomes was analyzed.Results:The standard deviation of blood glucose(SDBG),and the values of the mean amplitude of glycemic excursions(MAGE),the maximum amplitude of glycemic excursions(LAGE)and absolute mean daily difference(MODD)of the blood glucose level of the women in the study group were significantly higher than those of the women in the control group.The incidence of the adverse pregnancy outcomes of the women in the study group was significantly higher than that of the women in the control group.The values of SDBG(1.28±0.17 mmol/L),MAGE(3.37±0.31 mmol/L),LAGE(4.02±0.55 mmol/L)and MODD(0.72±0.11 mmol/L)of the women in group B were significantly lower than those(1.46±0.35)mmol/L,3.81±0.42 mmol/L,4.28±0.76 mmol/L and 0.85±0.13 mmol/L)of the women in group A.The adverse pregnancy outcomes rate of the women in group B was significantly lower than that of the women in group

关 键 词：妊娠期糖尿病 产程中血糖管理 血糖水平 不良妊娠结局 相关性 

分 类 号：R714.256[医药卫生—妇产科学]