不同诊断标准诊断妊娠期糖尿病的相关探讨

目的:探讨采用不同诊断标准诊断妊娠期糖尿病(GDM)对围生结局的影响。方法:选取2012年6月~2013年5月和2011年6月~2012年5月两个时段在本院行产前检查并住院分娩的孕妇,前一时段的对象按照国际糖尿病与妊娠研究组(IADPSG)标准诊断GDM(3216例,IADPSG组),后一时段对象按照美国国家糖尿病数据组(NDDG)标准诊断GDM(2985例,NDDG组),比较两组对象GDM发病率、并发症及围生结局。结果:GDM的发病率IADPSG组(15.73%,506/3216)明显高于NDDG组(5.46%,163/2985),NDDG组孕妇子痫前期、妊娠期肝内胆汁淤积症和羊膜腔感染的发病率明显高于IADPSG组,差异有统计学意义(P均0.01)。NDDG组早产儿和新生儿窒息发生率高于IADPSG组(P0.01)。结论:与NDDG标准相比,IADPSG标准诊断GDM发病率明显升高,采用IADPSG标准对减少子痫前期、羊膜腔感染、早产、新生儿窒息等不良围生结局有重要意义。

Different diagnostic criteria of gestational diabetes Mellitus

Objective： To investigate the relationship between different diagnostic criteria of gestational diabetes Melli- tus （GDM） and perinatal outcomes. Methods： The clinical data of pregnant women who had routine prenatal examine and delivery in our hospital from June 2012 to May 2013 and June 2011 to May 2012 were analyzed. They were diagnosed GDM according to International Association of Diabetes and Pregnancy Study Groups （IADPSG） standard （n= 3216 IADPSG group） or according to National Diabetes Data Group （NDDG） standard （n=2985, NDDG group）. The incidence of GDM, maternal complications and perinatal outcomes of women with GDM were evaluated. Results： The incidence of GDM in IADPSG group （15.73%, 506/3216） was significantly higher than that in NDDG group （5.46%, 163/2985）. The incidences of preeclampsia, intrahepatic cholestasis of pregnancy and amniotic infection in NDDG group were significantly higher than those of IADPSG group （P all〈 0.01）. The incidences of premature and neonatal asphyxia in NDDG group were significantly higher than those of IADPSG group （P 〈0.01）. Conclusion： Compared with NDDG group, the incidence of GDM is significantly higher in IADPSG group. The diagnosis of GDM using IADPSG standard has important implications for reducing the adverse perinatal outcomes, such as preeclampsia, amni- otic infection, premature delivery and neonatal asphyxia.