血清锌-α2-糖蛋白水平与高龄孕妇妊娠期糖尿病妊娠结局及新生儿结局的相关性分析

目的探讨血清锌-α2-糖蛋白(ZAG)水平与高龄孕妇妊娠期糖尿病妊娠结局及新生儿结局的相关性。方法回顾性选取2017年1月至2020年1月北京中医医院顺义医院收治的100例妊娠期糖尿病高龄孕妇资料,将其作为观察组,另取同期来我院体检的100名健康孕妇作为对照组。对两组孕妇的妊娠结局、新生儿结局与血清ZAG水平进行比较。将100例高龄孕妇妊娠期糖尿病中新生儿不良结局的26例患者与妊娠不良结局的17例患者分为不良结局组(n=43),将剩余患者分为结局良好组(n=57)。对比两组患者相关临床资料,并分析血清ZAG水平与高龄孕妇妊娠期糖尿病母婴不良结局的相关性。结果观察组新生儿不良结局发生率为26.00%。不良妊娠结局发生率为17.00%,对照组新生儿不良结局发生率为4.00%。不良妊娠结局发生率为5.00%,观察组明显高于对照组,而观察组产妇的ZAG水平为(27.58±8.58)μg/mL,明显低于对照组(39.52±11.74)μg/mL],差异均有统计学意义(P<0.05)。结局良好组与不良结局组产妇年龄、妊娠次数、分娩孕周、血尿素氮、血肌酐、白蛋白、血红蛋白水平对比差异无统计学意义(P>0.05),不良结局组产妇体重指数、产次、妊娠前糖尿病史患者比率和ZAG水平均高于结局良好组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示:妊娠前糖尿病史、ZAG为高龄孕妇妊娠期糖尿病母婴不良结局的独立影响因素(P<0.05)。结论高龄孕妇妊娠期糖尿病患者母婴不良结局发生率明显高于健康孕妇。且应用血清ZAG表达水平能够预测母婴不良结局发生率,因此临床针对孕期血清ZAG水平降低的孕妇可改良治疗措施,预防母婴不良结局的发生。

Correlation between serum zinc-α2-glycoprotein level and pregnancy outcome and neonatal outcomes in elderly pregnant women with gestational diabetes mellitus.

Objective To investigate correlation between serum zinc-α2-glycoprotein(ZAG)level and pregnancy outcome and neonatal outcome in elderly pregnant women with gestational diabetes mellitus.Methods A total of 100 pregnant women with gestational diabetes mellitus admitted to Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine from January 2017 to January 2020 were selected,and they were divided into the observation group.A total of 100 healthy pregnant women who were admitted to our hospital during the same period as control group.The pregnancy outcome,neonatal outcome and serum ZAG level were compared between the two groups.A total of 100 elderly pregnant women with gestational diabetes mellitus,26 cases of neonatal adverse outcomes and 17 patients with poor pregnancy outcomes were divided into adverse outcomes group(n=43).The remaining patients were divided into a good outcome group(n=57),the clinical data of the two groups of patients were compared,and the correlation between serum ZAG levels and adverse maternal and infant outcomes of gestational diabetes mellitus in elderly pregnant women was analyzed.Results The incidence of adverse neonatal outcomes in the observation group was 26.00%.The incidence of adverse pregnancy outcomes was 17.00%,and the incidence of adverse neonatal outcomes in the control group was 4.00%.The incidence of adverse pregnancy outcome was 5.00%,which was significantly higher in the observation group than that in the control group,the differences were statistically significant(P<0.05),while the ZAG level in the observation group was(27.58±8.58)μg/mL,which was significantly lower than that in the control group(39.52±11.74)μg/mL],the differences were statistically significant(P<0.05).There was no significant difference in the age,frequency of pregnancy,appointment and removal of gestational weeks,blood urea nitrogen,serum creatinine,albumin and hemoglobin between the group with good outcome and the adverse outcome group,the differences were statistically significant(P>0.05).The body mass index,parity,the proportion of patients with a history of pre-gestational diabetes and ZAG level in the adverse outcome group were higher than those in the good outcome group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that prediabetes history and ZAG were independent factors affecting maternal and fetal outcomes in elderly pregnant women with gestational diabetes mellitus(P<0.05).Conclusion The incidence of adverse maternal and fetal outcomes in elderly pregnant women with gestational diabetes mellitus is significantly higher than that of healthy pregnant women.The expression level of serum ZAG can predict the incidence of adverse maternal and infant outcomes.Therefore,clinical treatment measures can be improved for pregnant women with reduced serum ZAG levels during pregnancy to prevent the occurrence of adverse maternal and infant outcomes.