欧阳凯， 穆小萍， 黎　云， 刘　艳， 齐晓岚

(1.广东省妇幼保健院 检验科， 广东 广州　510010； 2.广东省妇幼保健院 产科， 广东 广州　510010； 3.贵州医科大学 分子生物学重点实验室， 贵州 贵阳　550004)



妊娠期糖尿病孕妇血糖水平对妊娠结局的影响*

欧阳凯1， 穆小萍1， 黎云2， 刘艳1， 齐晓岚3

(1.广东省妇幼保健院 检验科， 广东 广州510010； 2.广东省妇幼保健院 产科， 广东 广州510010； 3.贵州医科大学 分子生物学重点实验室， 贵州 贵阳550004)

目的： 探讨妊娠期糖尿病(GDM)孕妇控制血糖水平对妊娠结局的影响。方法： 选取定期产检并分娩的GDM孕妇共186例作为实验组，其中110例血糖控制不理想或未控制血糖的GDM孕妇作为实验1组，76例血糖控制在正常范围的GDM孕妇作为实验2组；选取同期100例健康孕妇作为对照组，比较3组孕妇妊娠期并发症及新生儿结局。结果： 实验1组中孕妇发生妊娠期高血压综合症、羊水过多、产后出血、子痫前期的发生率均高于实验2组和对照组，差异有统计学意义(P<0.05)；实验2组孕妇并发症发生率与对照组相比差异无统计学意义(P>0.05)；实验1组中新生儿早产儿、低体重儿、巨大儿、低血糖症、呼吸窘迫综合征、感染以及心肌损害的发生率均高于实验2组和对照组，差异有统计学意义(P<0.05)；实验2组中早产儿、低体重儿、巨大儿、低血糖症、新生儿呼吸窘迫综合征以及新生儿感染的发生率与对照组相比，差异无统计学意义(P>0.05)；心肌损害的发生率高于对照组，差异有统计学意义(P<0.05)。结论： 控制GDM孕妇血糖正常可明显改善妊娠结局。

糖尿病，妊娠； 血糖； 妊娠并发症； 新生儿结局

[Abstract]Objective: To investigate the impact of control the blood sugar level on pregnancy outcome in pregnant women with gestational diabetes mellitus (GDM). Methods: 186 pregnant women with GDM, were selected as experimental group. Among them, 110 pregnant women who did not control blood sugar or did not have ideal blood sugar control were selected as group 1 while the other 76 pregnant women whose blood sugar was controlled into the normal range were selected as group 2. Meanwhile, 100 healthy pregnant women of the same period were selected as control group. The complications of pregnancy and neonatal outcomes were compared between the 3 groups. Results: In the experimental group 1, the incidence of pregnancy induced hypertension, polyhydramnios, postpartum hemorrhage, preeclampsia was higher than their counterparts in experimental group 2 and the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of complications between experimental group 2 and control group(P>0.05). The incidence of low birth weight infants, low birth weight infants, low birth weight infants, low birth weight infants, hypoglycemia, respiratory distress syndrome, respiratory distress syndrome and myocardial injury in experimental group 1was significantly higher than their counterparts in experimental group 2 and the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of low birth weight infants, huge children, hypoglycemia, neonatal respiratory distress syndrome and neonatal infection rate between experimental group 2 and control group (P>0.05) but there was statistically significant difference in the incidence of myocardial injury, which was higher than that in control group(P<0.05). Conclusion: Control of normal blood glucose in GDM pregnant women can significantly improve pregnancy outcome.

[Key words]gestational diabetes mellitus; blood sugar; pregnancy complications; neonatal outcome

妊娠期糖尿病 (gestational diabetes mellitus, GDM) 是指在妊娠期间发现的糖尿病，包括糖耐量减低或糖尿病发作，不排除妊娠前存在糖耐量异常而未被确认者。但已知糖尿病伴妊娠者不属此型[1]。我国GDM发生率1%～5%，近年有明显增高的趋势[2]。GDM是妊娠期最重要……