妊娠期糖尿病合并多囊卵巢综合征患者的不良临床结局分析

目的对妊娠期糖尿病(gestational diabetes mellitus,GDM)合并多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者在妊娠过程中的临床不良结局进行分析,有助于对此类患者进行相关筛查、诊断及干预,减少不良并发症的发生。方法选取2014年1月至2016年1月在延安大学附属医院进行产前检查确诊为GDM的199例孕妇,其中102例PCOS患者纳入PCOS组,97例非PCOS患者为对照组。观察比较两组患者的妊娠结局(妊娠期高血压、子痫前期、早产、羊水过多及羊水过少、剖宫产率)和新生儿结局(新生儿体重、巨大胎儿、新生儿Apgar评分、新生儿黄疸、呼吸窘迫综合征及低血糖),并将两组患者中有统计学差异的指标进行Logistic回归分析。结果两组患者早产、羊水过多、羊水过少、剖宫产、新生儿体重、巨大胎儿、新生儿Apgar评分、新生儿黄疸及呼吸窘迫综合征的发生率比较,差异均无统计学意义(P0.05)。将有统计学差异的指标纳入Logistic回归分析发现:PCOS组中妊娠期高血压、子痫前期和新生儿低血糖的发生风险显著增高(P0.05)。结论PCOS增加GDM孕妇的妊娠期高血压、子痫前期和新生儿低血糖患病风险。

Analysis of adverse clinical outcomes in patients with gestational diabetes mellitus and polycystic ovary syndrome

Objective To investigate the adverse clinical outcomes in patients with gestational diabetes mellitus ( GDM) and polycystic ovary syndrome ( PCOS) .Then the patients can be screened out , diagnosed and to reduce adverse complications .Methods Pregnant women diagnosed with GDM in Affiliated hospital of Yan’an University from January 2014 to January 2016 were selected. 102 patients complicated with PCOS were divided into PCOS group and the other 97 cases were divided into control group .The pregnancy outcomes ( including gestational hypertension , preeclampsia , premature birth , polyhydramnios , oligohydramnios and cesarean delivery ) and neonatal outcomes ( including birth weight , fetal macrosomia , neonatal Apgar score , neonatal jaundice , respiratory distress syndrome and hypoglycaemia ) of patients of two groups were observed and compared .And the results were statistically different by logistic regression analyze .Results The difference of the rate of premature birth , polyhydramnios , oligohydramnios ,cesarean delivery , low birth weight , fetal macrosomia , neonatal Apgar score , neonatal jaundice and respiratory distress syndrome in the two groups were not statistically significant (P>0.05).The incidence of gestational hypertension (P=0.003, 95 %CI=1.59~5.02,OR=2.82), preeclampsia(P=0.038,95 %CI=1.28~4.52,OR=2.40) and neonatal hypoglycemia (P=0.003,95%CI=1.45~6.21,OR=3.21) in PCOS group were significantly higher (P<0.05).Conclusion PCOS increase the risk of gestational hypertension , preeclampsia and neonatal hypoglycemia in GDM pregnant women .