妊娠期糖尿病危险因素及血糖干预对妊娠结局的影响.doc

妊娠期糖尿病危险因素及血糖干预对妊娠结局的影响

【摘要】目的探讨妊娠期糖尿病（GDM）发病的危险因素及血糖控制对母婴妊娠结局的影响。方法收集确诊的140例GDM患者作为病例组和140例正常孕妇为对照组，根据血糖控制情况将GDM病例分为血糖控制良好组（83例）和控制不良组（57例）；分析影响GDM发病的危险因素，比较血糖控制良好组和不良组母婴妊娠结局及并发症发生情况。结果多因素分析结果显示，超重或肥胖（OR=3.019）、妊娠年龄（OR=1.568）、高血红蛋白血症（OR=1.519）、月经周期紊乱（OR=2.018）、不良孕产史（OR=2.815）、糖尿病家族史（OR=4.948）均为GDM发病的危险因素。血糖控制不良组的妊娠期高血压疾病、羊水过多、酮症酸中毒、产后出血、剖宫产等并发症发生率均明显高于控制组（P<0.05）；控制不良组的早产、巨大儿、新生儿窒息、新生儿低血糖、高胆红素血症等并发症发生率明显高于控制组（P<0.05）。结论应重视GDM发病的危险因素，早发现、早诊断、早治疗GDM，重点控制妊娠期血糖水平，从而降低GDM对母婴妊娠结局的影响。
【关键字】妊娠期糖尿病；妊娠结局；并发症；危险因素；血糖
RiskFactorsofGestationalDiabetesMellitusandPregnancyOutcomeAffectedbyBloodSugarIntervention

【Abstract】ObjectiveToexploretheriskfactorsofgestationaldiabetesmellitus(GDM),andstudytheeffectofbloodsugarinterventionaffectingpregnancyoutcome.MethodsWithcase-controlstudymethod,140casesofGDMpatientsascasegroupand140caseswithoutthisdiseaseascontrolgroupwerecollected.GDMcasesweredividedintogoodbloodsugarcontrolgroup(83cases)andnotgoodcontrolgroup(57cases)accordingtobloodsugarcontrolcondition.TheriskfactorsofGDMwereanalyzedandpregnancyoutcomeandcomplicationswerecomparedbetweengoodandnotgoodcontrolgroups.ResultsMultiplefactorsLogisticRegressionanalysisresultshowedthatoverweightorobesity(OR=3.019),gestationalage(OR=1.568),hyperhemoglobinemia(OR=1.519),menstrualcycledisorder(OR=2.018),adversepregnancyhistory(OR=2.815),historyofdiabetesmellitus(OR=4.948).Thecomplicationsincidenceratesofpregnancy-inducedhypertensionsyndrome,hydramnios,ketoacidosis,postpartumhemorrhage,uterine-incisiondelivery,prematuredelivery,largefordateinfant,neonatalasphyxia,hypoglycemiaofnewbornandhyperbilirubinemiainnotgoodcontrolgroupweremuchhigherthannotgoodcontrolgroup(P<0.05).ConclusionWeshouldthinkhighlyoftheriskfactorsofGDM,earlydiscovering,earlydiagnosingandearlytreatingGDM,especiallycontrollingbloodsugarlevel,thuscutdowntheeffectofGDMtopregnancyoutcome.
【Keywords】Gestationaldiabetesmellitus;Pregnancyoutcome;Complication;Riskfactors;Bloodsugar

妊娠期糖尿病（Gestationaldiabetesmellitus