不同时期糖筛对妊娠期糖尿病患者母儿预后的影响

目的:观察不同时期进行糖筛对妊娠期糖尿病患者母儿预后的影响。方法:将2005年7月～2008年1月在我院进行系统产前检查的孕妇随机分成两组,一组于孕早期(<16周)之前行50g糖筛(GCT),其确诊的GDM患者为GDM1组,另一组常规于24～28周行首次糖筛,其确诊的GDM患者为GDM2组。同时期未在我院进行系统产前检查,孕34周后来诊及住院分娩并确诊为GDM的患者为GDM3组,3组GDM患者之间及与正常孕妇作对照进行母儿并发症的比较。结果:GDM1、2组孕妇妊娠期高血压疾病、羊水过多、酮症酸中毒发生率明显低于GDM3组。其中GDM1组孕妇的各种并发症明显低于另外两组,在胎膜早破发生率与羊水过多的发生率上与正常对照组无明显差异(P>0.05)。其中GDM1组新生儿除新生儿低血糖发生率略高于对照组外,其余早产率、巨大儿发生率与正常对照组比较差别无显著意义。结论:孕期进行糖筛并行相应治疗可大大降低GDM患者母儿并发症,对高危孕妇应于早孕时即行糖筛,并纳入系统管理,可明显降低其母儿并发症及胰岛素的使用量,改善母儿预后。

Research on the effect of glucose tolerance screening on the prognosis of mothers and infants in different gestational ages

Objective:To observe the effect of glucose tolerance screening on the prognosis of mothers and infants in different gestational ages.Methods:From July 2005 to January 2008,a total of 236 pregnant women diagnosed as GDM in this hospital were divided into 3 groups according to screening time,group 1 diagnosed in the first trimester(<16 week) underwent 50 g oral glucose challenge test(GCT),group 2 diagnosed in the second trimester(24～28 week) underwent GCT,group 3 diagnosed in the third trimester(>34 week) didn't undergo GCT.Complications incidences of mothers and infants were analyzed between the 3 groups and normal group without GDM.Results:Incidences of pregnancy induced hypertension,hydramnios,ketoacidosis in group 1 and group 2 were significantly lower than those in group 3.In group 1,all of the complications incidences of mothers were significantly lower than those in group 2 and group 3.Incidences of premature rupture in fetal membranes and hydramnion in mothers had no significant difference between group 1 and normal group.In group 1,incidence of hypoglycemia was higher than that in normal group,while incidences of premature delivery and giant baby had no significant difference between the two groups.Conclusion:Glucose tolerance screening and treatment in pregnancy can apparently decrease complication incidents of GDM mothers and their infants.For the high risk pregnant women,glucose tolerance screening in first trimester and admitted to system management can decrease insulin dosage,decrease complication incidents of mothers and infants apparently,improve their prognosis.