古岭梅　温曲英　万晓英

[摘要] 目的 探討妊娠期糖尿病对母婴结局的影响。 方法 选取2014年6月～2016年8月于惠州仲恺高新区人民医院住院分娩的妊娠期糖尿病孕妇92例作为研究组，同期分娩的92名健康孕妇作为对照组。记录两组孕产妇并发症和围生儿结局的差异。孕产妇的并发症包括胎盘早破、妊娠期高血压疾病、羊水过多、剖宫产、自然流产、感染；围生儿结局包括新生儿低血糖、巨大儿、新生儿窒息、新生儿胆红素血症、围生儿死亡。 结果 孕产妇并发症：研究组胎盘早破、妊娠期高血压疾病、羊水过多，剖宫产、自然流产、感染等并发症的发生率明显高于对照组，差异有统计学意义（P < 0.05）。围生儿结局：研究组新生儿低血糖、巨大儿、新生儿窒息发生率和围生儿死亡率明显高于对照组，差异有统计学意义（P < 0.05）。两组新生儿高胆红素血症发生率比较，差异无统计学意义（P > 0.05）。 结论 妊娠糖尿病会影响母婴的健康，应及时发现，早期干预和治疗，以便获得良好的妊娠结局。

[关键词] 妊娠期糖尿病；母婴；妊娠结局；临床分析

[中图分类号] R714.256 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0071-04

Effect of gestational diabetes mellitus on maternal and infant outcome

GU Lingmei1 WEN Quying2 WAN Xiaoying1 LIU Caihong1

1.Department of Obstetrics， People′s Hospital of Zhongkai Hi-tech Indutrial Development Zone of Huizhou City， Guangdong Province， Huizhou 516229， China； 2.Operation Room， Huizhou Central People′s Hospital， Guangdong Province， Huizhou 516008， China

[Abstract] Objective To explore the effect of maternal and neonatal outcomes of gestational diabetes mellitus. Methods From June 2014 to August 2016， 92 gestational diabetes mellitus pregnant women hospitalized in People′s Hospital of Zhongkai Hi-tech Indutrial Development Zone of Huizhou City were randomly selected as the study group， and 92 healthy pregnant women in the same period were used as the control group. The differences between the two groups of pregnant and parturition and perinatal outcome were recorded. The complications of pregnant and lying-in women included premature rupture of placenta， hypertension of pregnancy， excessive amniotic fluid， cesarean section， spontaneous abortion and infection. Perinatal outcomes included neonatal hypoglycemia， giant infants， neonatal asphyxia， fetal anoxia， neonatal bilirubinemia， and perinatal mortality. Results The incidences of premature rupture of placenta， hypertension of pregnancy， excessive amniotic fluid， cesarean section， spontaneous abortion， infection and other complications were significantly higher than those in the control group respectively， the differences were statistically significant （P < 0.05）. Perinatal outcome： the rate of neonatal hypoglycemia， giant infants， neonatal asphyxia and perinatal mortality were significantly higher than those in the control group respectively， with statistically significant difference （P < 0.05）. There was no significant difference in the incidence of hyperbilirubinemia between the two groups （P > 0.05）. Conclusion Gestational diabetes mellitus can affect the health of mother and infant， and should be discovered in time， early intervention and treatment in order to obtain good pregnancy outcome.

[Key words] Gestational diabetes mellitus； Pregnancy； Pregnancy outcome； Clinical analysis

妊娠期糖尿病（gestational diabetes mellitus，GDM）是指孕妇在妊娠前糖代谢正常而在妊娠期间第一次发生糖耐量降低或糖尿病。由于人群分布差异及各地饮食结构和习惯的不相同，GDM的发生率为1%～5%[1]，随着人民生活水平的提高，其发病率正呈逐年增高趋势[2]。GDM可引起胎膜早破、妊娠期高血压疾病、羊水过多、剖宫产、自然流产、感染、巨大儿（出生体重≥4 kg）、新生儿窒息、胎儿缺氧、新生儿胆红素血症等，严重威胁孕妇和围生儿的生命安全，是其死亡率增高的主要危险因素之一，应该引起妊娠期妇女的足够重视。GDM对母婴结局的影响也引起越来越多专家学者的重视，在妊娠期间发现GDM及早干预治疗不但能够改善妊娠的结局，而且能够降低母婴的远期并发症[3-5]。……