摘要
目的 评价应用妊娠期糖尿病（gestational diabetes mellitus,GDM）新诊断标准后患者的母儿结局及一日门诊的效果. 方法 回顾性分析在北京大学第一医院妇产科2011年7月1日至2012年6月30日分娩的GDM孕妇（GDM组）841例和糖代谢正常孕妇3 043例（糖代谢正常组）的临床资料,探讨GDM孕妇参加一日门诊（研究组605例）和未参加一日门诊（对照组236例）的母儿结局差异.采用成组t检验或x2检验对数据进行统计学分析. 结果 （1） GDM组孕妇平均年龄（31.5±4.2）岁,稍高于糖代谢正常组的（30.0±3.7）岁（t=9.13,P＜0.01）.研究组的平均年龄为（31.7±4.2）岁,与对照组平均年龄[（31.7±4.9）岁]相比,差异无统计学意义（t=2.32,P＞0.05）.研究组口服葡萄糖耐量试验（oral glucose tolerance test,OGTT）空腹血糖水平为（5.2±0.5） mmol/L,稍低于对照组的（5.3±0.8） mmol/L,差异有统计学意义（t=2.48,P＜0.05）.2组OGTT服糖后l和2h血糖水平差异无统计学意义（P值均＞0.05）.（2） GDM组和糖代谢正常组孕妇巨大儿的发生率分别为6.5％（55/841）和5.9％（182/3 043）,差异无统计学意义（x2=0.36,P＞0.05）.GDM组孕妇早产率明显高于糖代谢正常组[10.1％（83/841）与7.4％（225/3 043）,x2=5.56;P＜0.05],妊娠期高血压和轻度子痫前期的发生率亦明显高于糖代谢正常组[妊娠期高血压：4.2％ （35/841）与2.6％（82/3 043）,x2=4.85;轻度子痫前期：1.7％（14/841）与0.9％（26/3 043）,x2=4.24;P值均＜0.05],而2组重度子痫前期的发生率[分别为2.4％（20/841）与1.6％（49/3 043）]差异无统计学意义（x2=2.22,P＞0.05）.（3）GDM组孕妇妊娠期胰岛素使用率为9.3％（78/841）.其中研究组胰岛素使用率为7.9％（48/605）,对照组为11.9％（28/236）,差异无统计学意义（x2=3.54,P＞0.05）.2组巨大儿和妊娠期高血压疾病的发生率相似[巨大儿：6.9％（42/605）与5.3％（13/236）
Objective To evaluate the results of one-day care for gestational diabetes mellitus （GDM） and pregnancy outcome after application of new diagnostic criteria.Methods We retrospectively analyzed the clinical features of a GDM group （n=841） and a normal glucose metabolism group （n=3 043） who delivered in Department of Obstetrics and Gynecology,Peking University First Hospital between July 1,2011 and June 30,2012,to discuss the difference in maternal and newborn outcomes between these two groups,and to compare the maternal and newborn outcomes between the GDM one-day care group （study group,n=605） and non-GDM one-day care group （control group,n=236）.Statistical analysis was performed by t test and x2 test.Results The average age of pregnant women with GDM was （31.5±4.2） years,which was higher than the normal glucose metabolism group （30.0±3.7） years （t=9.13,P＜0.01）.The average age of the study group was （31.7±4.2） years,and the average age of the control group was （31.7±4.9） years,which was not a significant difference （t=2.32,P＞0.05）.In the oral glucose tolerance test,fasting blood glucose level was （5.2±0.5） mmol/L,which was significantly lower than that in the control group （5.3±0.8） mmol/L （t=2.48,P＜0.05）.The difference between 1 and 2 h glucose sugar levels did not differ significantly （P＞0.05） between the two groups.In the GDM and normal glucose metabolism groups of pregnant women,the incidence of macrosomia was 6.5％ （55/841） and 5.9％ （182/3 043）,respectively,although the difference was not significant （x2=0.36,P＞0.05）.In the GDM group,the rate of premature delivery was significantly higher than in the normal glucose metabolism group [preterm birth：10.1％ （83/841） and 7.4％ （225/3 043）,x2=5.56; P＜0.05）].In the GDM group,gestational hypertension and mild pre-eclampsia were significantly more frequent than in the normal glucose metabolism group [gestational hypertension：4.2％ （35/841） vs 2.6％ （82
出处
《中华围产医学杂志》
CAS
北大核心
2014年第3期186-190,共5页
Chinese Journal of Perinatal Medicine
关键词
妊娠期糖尿病
一日门诊
巨大儿
Gestational diabetes mellitus
One-day care
Macrosomia
