妊娠期糖尿病孕婦圍生期母嬰結局分析

羅莉　陳莉

[摘要] 目的 分析妊娠期糖尿病孕婦圍生期母嬰結局。 方法 回顧性分析2015年1月～2016年1月在本院分娩的121例妊娠期糖尿病孕婦（A組）與同期121例正常孕婦（B組）圍生期母嬰結局。 結果 A、B兩組患者的羊水情況比較，其羊水過多、羊水過少發生率差異無統計學意義（P>0.05），A、B兩組產婦產后出血進行比較后，產后出血發生率差異無統計學意義（P>0.05）；A、B兩組胎膜早破比較，差異有統計學意義（P<0.01）；將A、B兩組順產及剖宮產率比較，其發生率差異無統計學意義（P>0.05）。A、B兩組早產兒的發生率無統計學意義（P>0.05），兩組新生兒窒息、肺炎、黃疸等發生率比較差異無統計學意義（P>0.05）。GDM孕婦更易發生巨大兒及新生兒低血糖，同時低體重兒發生率較高，差異有統計學意義（P<0.05）。 結論 GDM孕婦胎膜早破、巨大兒、新生兒低血糖、低體重兒較正常孕婦發生率高。

[關鍵詞] 妊娠期糖尿病孕婦；圍生期母嬰結局；低血糖；羊水；巨大兒

[中圖分類號] R587.1 [文獻標識碼] B [文章編號] 1673-9701（2017）36-0058-03

[Abstract] Objective To analyze the perinatal maternal and fetal outcomes in pregnant women with gestational diabetes. Methods The perinatal maternal and fetal outcomes of 121 pregnant women with gestational diabetes mellitus （Group A） and 121 normal pregnant women（Group B） with gestational age labored in our Hospital of from January 1， 2015 to January 1， 2016 were retrospectively analyzed. Results There was no significant differences in incidences of polyhydramnios and oligohydramnios between the group A and group B（P>0.05）. The postpartum hemorrhage between group A and group B was compared， suggesting there was no significant difference in the incidence of postpartum hemorrhage（P>0.05）. There was statistically significant difference in the premature rupture of membranes between group A and group B （P<0.01）. The rates of natural labor and cesarean section in group A and group B were compared， and there were no significant differences in the rates between the two groups（P>0.05）. There was no significant difference in the incidence of preterm infants between group A and B（P>0.05）. There were no significant differences in the incidences of neonatal asphyxia， pneumonia and jaundice between the two groups（P>0.05）. GDM pregnant women were more prone to macrosomia and neonatal hypoglycemia， and the incidence of low birth weight children was higher， all with statistically significant difference（P<0.05）. Conclusion The incidences of premature rupture of membranes， macrosomia， neonatal hypoglycemia and low birth weight children in GDM pregnant women are higher than those of normal pregnant women.

[Key words] Gestational diabetes mellitus； Perinatal maternal and fetal outcomes； Hypoglycemia； Amniotic fluid； Macrosomia

作為臨床中一種極為常見的婦產科多發病，妊娠期糖尿病（gestational diabetes mellitus，GDM）主要指的是妊娠前糖代謝正常而在妊娠期發生的糖尿病病癥[1]，全球肥胖的持續流行增加了育齡婦女妊娠期糖尿病發生率，其一方面增加了圍產期孕婦及胎兒的患病風險[2]，另一方面也導致孕婦產后2型糖尿病發生風險的增高，GDM發生率世界各國報道約為1%～14%。我國GDM發病率約為1%～5%[3]。本文旨在回顧性分析2015年1月～2016年1月在本院分娩的121例妊娠期糖尿病孕婦（A組）與同期121例正常孕婦（B組）圍生期母嬰結局。由專業的產科醫師對妊娠期糖尿病孕婦進行體重及飲食指導，效果不顯著的孕婦加用胰島素治療，合理控制血糖。將孕產婦與妊娠期糖尿病相關的并發癥、分娩方式及圍生兒情況及并發癥進行對照分析，一方面為臨床上對妊娠期糖尿病的管理提供參考，另一方面為提升妊娠期糖尿病圍生期結局提供借鑒，現報道如下。