妊娠期糖尿病的筛查和治疗对妊娠结局的影响

目的：探讨妊娠期糖尿病（GDM）筛查和治疗对妊娠结局的影响。方法：选择GDM孕妇208例（GDM组）和健康孕妇192例（对照组）,对两组孕妇一般情况、妊娠结局及围产儿结局进行比较。结果：GDM组孕妇平均年龄明显高于对照组,孕周低于对照组,差异有统计学意义（P均〈0.05）。而两组孕妇在体重、孕次、产次等方面的差异无统计学意义（P〉0.05）。两组妊娠结局比较,GDM组早产、剖宫产、妊娠期高血压发生率均明显高于对照组（P均〈0.05）,胎膜早破、羊水过多、产后出血的发生率差异无统计学意义（P均〉0.05）。两组巨大儿、低体重儿、高胆红素血症、新生儿体血糖、新生儿窒息发生率差异无统计学意义（P〉0.05）。结论：加强GDM筛查,及早诊断,通过饮食、运动及胰岛素等系统化治疗及规范化管理,可以有效控制血糖,减少妊娠合并症及改善围生儿预后。

The Effect of Screeing and Treatment of Gestational Diabetes Mellitus on Pregnancy Outcome

Objective： To explore the influence of screeing and treatment of gestational diabetes（ GDM）on pregnancy outcome. Method： 208 pregnant women with GDM were as GDM group and 192 pregnant women were defined as healthy control group. The maternal and perinatal complications were compared between the two groups. Result： The average age of GDM group was obviously higher than that of control group,and the gestational weeks was lower than that in control group,the difference was statistically significant（ P〈0.05）. The weight,gravidity times and parity were no significantly different between GDM group and control group（ P〈0.05）. The premature delivery rate,cesarean birth rate and gestational hypertension in GDM group were higher than those in the control group（ P〉0.05）. The incidences of pregnancy-induced polyhydramnios,premature rupture of membranes,postpartum hemorrhage in two groups were statistical in significance（ P〉0.05）. There were no distinct differences in the morbidity of fetal macrodome,low birth weight,hypoglycemia,asphyxia neonatorium and hyperbilirubinemia of newborn between the two groups（ P〈0.05）. Conclusion： Proper perinatal GDM screening and standardized treatment are important to control the level of serum glucose and decrease the maternal and perinatal complications.