两种妊娠期糖尿病诊断标准与妊娠结局分析

目的：对两种妊娠期糖尿病的诊断标准及妊娠结局进行分析,以探讨GDM的适宜诊断。方法：对我院分娩的8109例孕妇进行血糖筛查试验,阳性者进行葡萄糖耐量试验（OGTT）。按照教科书和IADPSG两种诊断标准对孕妇进行诊断并分组,非糖尿病孕妇从中抽取450例作为对照组,对各组母儿妊娠结局进行比较。结果：利用第7版《妇产科学》标准,GDM的诊断率为1.9%;利用IADPSG诊断标准,GDM的诊断率为2.8%;两组间在剖宫产率、妊娠期高血压疾病、羊水过多、巨大儿、早产、低体重儿等的发生率方面均无显著性差异（P〉0.05）,而与对照组相比,巨大儿、早产发生率存在显著性差异（P〈0.05）;IADPSG组剖宫产率及妊娠期高血压疾病发生率与对照组比较,亦有统计学意义（P〈0.05）。结论：GDM的诊断和治疗要及时,两种诊断标准围产期结局无显著差异;但采用IADPSG诊断标准将会使更多孕妇纳入诊断,有利于早期干预,减少母婴并发症的发生。

Analysis of two kinds of diagnostic criteria for gestational diabetes mellitus and pregnancy outcome

Objective： Analysis of two kinds of diagnostic criteria for gestational diabetes mellitus and pregnancy outcome, to explore a feasible diagnosis for GDM. Methods：A total of 8109 pregnant women who deliveried in my hospitol received 50g glucose screening test.Positive subjects received a 75g oral g1ucose tolerance test （OGTT）. The diagnosis of GDM were according to two diagnostic criteria： the seventh edition of ＂Obstetrics and Gynecology＂ and IADPSG （the international association of diabetes and pregnancy study groups）. 450 negative screeners were selected as control group.The outcomes of the mother and the neonate of these groups were compared.Results： The diagnosis rate of GDM was 1.9% according to the criterion of the seventh edition of ＂ Obstetrics and Gynecology＂;the diagnosis rate of GDM was 2.8% according to the diagnostic criterion of IADPSG;Between the two groups in the rate of cesarean section, hypertensive disorders in pregnancy, polyhydramnios, fetal macrosomia, premature delivery, low birth weight, the incidence rate showed no significant difference （P〈0.05）, but there was significant difference compared with the control group in fetal macrosomia and premature delivery （P〈0.05）. IADPSG group in cesarean section rate and hypertension disorder complicating pregnancy rate compared with the control group, there was significant difference （P〈0.05）. Conclusions： GDM diagnosis and therapy should be timely.There was no significant difference among the two kinds of diagnostic criteria for pregnancy outcome.But using IADPSG diagnostic criteria will be more into the diagnosis of pregnant women,it is advantageous to interven early,and reduce maternal and child complications.