妊娠期糖尿病新诊断标准对妊娠结局的意义

目的 探讨妊娠期糖尿病（gestational diabetes mellitus,GDM）新诊断标准实施前后1年对妊娠期糖尿病的诊断率、孕妇及围生儿临床结局的意义.方法 收集我院执行新诊断标准前后一年的同年龄段、孕前体重指数（BMI）在正常范围即18.5≤ BMI＜ 23,孕前无内科合并症及不良妊娠史的产妇分为A组（2234例）和B组（2012例）,分析GDM诊断率,孕产妇和围生儿并发症率方面有无差异.结果 经新诊断标准纳入并治疗后,B组妊娠期高血压、羊水过多、巨大儿、新生儿低血糖发生率低于A组,P＜0.01;B组切口感染、新生儿呼吸窘迫综合症也低于A组P＜0.05;胎膜早破、产后出血及早产、死胎、胎儿生长受限差异无统计学意义,P＞0.05.结论 执行GDM新诊断标准指导临床血糖管理可以降低母儿并发症,且不会增加胎儿生长受限.

The significance of the new diagnostic code of GDM on the pregnancy outcome

Objective To discuss the clinical result of maternal and fetus between the new diagnostic code of gestational diabetes mellitus （GDM） excution anterior-posterior one year, and change of diagnosis ratio. Methods According to the same age stage,range of BMI（ 18.5 ≤ BMI 〈 23）,without of complication of internal medicine and bad history of pregnancy before gesta- tion,we collected pregnant wowen beween January. 2009 and January. 2011 and classified into A group （2234cases） and B group （2012cases） by the two diagnostic code of GDM. The difference of GDM diagnosis ratio,complication of aternal and fetus were an- alyzed. Result Through diagnosis and treatment by new diagnostic code, the morbidity of PIH, polyhydramnios, fetal macroso- mia,hypoglycemia of newborn in B group were lower than those in A group （P 〈 0.01 ）, the morbidity of postoperative infection, ARDS of newborn in B group were lower than those in A group too （ P 〈 0. 05 ）, but the morbidity of PROM, postpartum hemor- rhage,premature labor,dead fetus,FGR had no statistically significant（P 〉 0.05）. Conclusion To carry out the new diagnostic code of GDM and to guide managing blood glucose, that could decrease the complication of maternal and fetus, but could not in- crease the morbidity of FGR.