罗莉　陈莉

[摘要] 目的 分析妊娠期糖尿病孕妇围生期母婴结局。 方法 回顾性分析2015年1月～2016年1月在本院分娩的121例妊娠期糖尿病孕妇（A组）与同期121例正常孕妇（B组）围生期母婴结局。 结果 A、B两组患者的羊水情况比较，其羊水过多、羊水过少发生率差异无统计学意义（P>0.05），A、B两组产妇产后出血进行比较后，产后出血发生率差异无统计学意义（P>0.05）；A、B两组胎膜早破比较，差异有统计学意义（P<0.01）；将A、B两组顺产及剖宫产率比较，其发生率差异无统计学意义（P>0.05）。A、B两组早产儿的发生率无统计学意义（P>0.05），两组新生儿窒息、肺炎、黄疸等发生率比较差异无统计学意义（P>0.05）。GDM孕妇更易发生巨大儿及新生儿低血糖，同时低体重儿发生率较高，差异有统计学意义（P<0.05）。 结论 GDM孕妇胎膜早破、巨大儿、新生儿低血糖、低体重儿较正常孕妇发生率高。

[关键词] 妊娠期糖尿病孕妇；围生期母婴结局；低血糖；羊水；巨大儿

[中图分类号] R587.1 [文献标识码] B [文章编号] 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

作為临床中一种极为常见的妇产科多发病，妊娠期糖尿病（gestational diabetes mellitus，GDM）主要指的是妊娠前糖代谢正常而在妊娠期发生的糖尿病病症[1]，全球肥胖的持续流行增加了育龄妇女妊娠期糖尿病发生率，其一方面增加了围产期孕妇及胎儿的患病风险[2]，另一方面也导致孕妇产后2型糖尿病发生风险的增高，GDM发生率世界各国报道约为1%～14%。我国GDM发病率约为1%～5%[3]。本文旨在回顾性分析2015年1月～2016年1月在本院分娩的121例妊娠期糖尿病孕妇（A组）与同期121例正常孕妇（B组）围生期母婴结局。由专业的产科医师对妊娠期糖尿病孕妇进行体重及饮食指导，效果不显著的孕妇加用胰岛素治疗，合理控制血糖。将孕产妇与妊娠期糖尿病相关的并发症、分娩方式及围生儿情况及并发症进行对照分析，一方面为临床上对妊娠期糖尿病的管理提供参考，另一方面为提升妊娠期糖尿病围生期结局提供借鉴，现报道如下。