妊娠期糖尿病治疗干预对妊娠结局的影响.doc

妊娠期糖尿病治疗干预对妊娠结局的影响 杜昂鹰1，杜晓红2，郑淑娟3 作者单位：四川省妇幼保健院 （四川 成都 610021） 摘要：目的：探讨妊娠期糖尿病（GDM）新诊断标准实施以来GDM流行病学分析及治疗干预措施对妊娠结局的影响。方法：回顾性分析2011-4-1至2012-8-1之间至本院就诊的妊娠期糖尿病患者病历资料。根据是否接受正规血糖监测及治疗分为治疗组及对照组。对比两组不良妊娠结局发生率之间的差异。结果：共计964名妊娠期糖尿病患者纳入研究，治疗组506人，对照组458人。治疗组中孕妇体重增长明显低于对照组；不良妊娠结局发病率（巨大儿，新生儿呼吸窘迫综合症，产后高胆红素血症，子痫前期，产程异常，胎膜早破，早产，产后感染）明显低于于对照组。结论：新标准实施后GDM发病率明显增高。针对新标准下GDM孕妇采取更简洁的血糖监测仍是有效的，GDM正规治疗明显降低巨大儿，胎膜早破，早产，产程延长，子痫前期等并发症发病率；显著降低孕妇体重增长及胎儿体重增长。 关键词：妊娠期糖尿病 治疗 妊娠结局 Effects of treatments for gestational diabetes mellitus on perinatal outcomes Du Angying, Du Xiaohong, Zheng Shujuan Sichuan provincial Hospital of Women and Children’s Health, Chengdu 610021, Sichuan province, China Abstracts: objects: To study the Gestational diabetes mellitus (GDM) epidemiology and the effects of intervention in pregnancy on perinatal outcomes since the new criteria of diagnosis of GDM carrying out. Methods: This was a retrospective case-based study. 964 Patients with GDM delivered in the tertiary obstetric hospital from 1st April 2011 to 1st August 2012 enrolled in the study. The perinatal outcomes of Patients received regular blood glucose monitoring and glucose control intervention (intervention group, n=506) compared with patients received routine prenatal care only (control group, n=458). Results: The weight gain of the patients in the intervention group was lower than the control group. The rates of pregnancy complications (Macrosomia; Respiratory distress syndrome; hyperbilirubinemia; preeclampsia, abnormal labor, premature rupture of membranes, preterm delivery, postpartum infection) in the intervention group were lower than control group. Conclusion: The incidence of GDM increased significantly after the new criteria of GDM diagnosis carrying out. Less intensive glucose monitoring was still effective and probably more feasible. The intervention of GDM decreased the rates of pregnancy complications (Macrosomia; Respiratory distress syndrome; hyperbilirubinemia; pre