摘要
目的:研究妊娠期糖尿病(GDM)孕产妇口服葡萄糖耐量试验(OGTT)不同时点血糖指标异常对妊娠结局的影响。方法:选择2018年10月—2020年11月在南通市妇幼保健院定期进行产前检查并分娩的373例GDM孕产妇作为研究对象。孕产妇在孕24~28周时,行口服75g葡萄糖耐量试验,其中仅1项血糖升高为Ⅰ组(空腹血糖升高为Ⅰ-A组,1h血糖升高为Ⅰ-B组,2h血糖升高为Ⅰ-C组);2项血糖升高为Ⅱ组(空腹及1h血糖升高为Ⅱ-A组,空腹及2h血糖升高为Ⅱ-B组,1h及2h血糖升高为Ⅱ-C组);3项血糖升高为Ⅲ组。分析GDM孕产妇妊娠结局。结果:(1)Ⅱ组、Ⅲ组孕产妇的孕次多于Ⅰ组(t值分别为8.601和7.491,P值均<0.05),Ⅲ组不良孕产史的发生率高于Ⅰ组(χ^(2)=9.608,P<0.05);(2)Ⅲ组孕产妇妊娠期高血压和羊水异常发病率均高于Ⅰ组和Ⅱ组(Ⅰ组χ^(2)值分别为11.483、6.757,Ⅱ组χ^(2)值分别为5.106、7.163,P值均<0.05);(3)Ⅰ-A组孕产妇妊娠期高血压发生率高于Ⅰ-B和Ⅰ-C组(χ^(2)值分别为7.874和5.817,P值均<0.05),Ⅱ-A、Ⅱ-B组巨大儿发病率高于Ⅱ-C组(χ^(2)值分别为5.241和4.968,P值均<0.05)。结论:OGTT异常点数量多的孕产妇孕次多,不良孕产史发生率高,妊娠期高血压、妊娠期肝内胆汁淤积症、羊水异常、剖宫产等不良结局增多,且异常点越多,情况越显著;在仅1项血糖异常时,空腹血糖异常者的妊娠期高血压发病率高于服糖后血糖异常者。因此,加强对GDM孕产妇的分类管理和精准治疗非常重要。
OBJECTIVE To study the influence of abnormal blood glucose index at different time points of oral glucose tolerance test(OGTT)on pregnancy outcome.METHODS 373 pregnant women with GDM who had undergone regular antenatal checkups and delivered at Nantong Maternal and Child Health Hospital from October 2018 to November 2020 were selected.Only one abnormal blood glucose of OGTT result was in groupⅠ(abnormal fasting blood glucose is in groupⅠ-A,patients with abnormal values at 60 minutes were in groupⅠ-B,and patients with abnormal values at 120 minutes were in groupⅠ-C);two abnormal blood glucose of OGTT result were in GroupⅡ(patients with abnormal values at fasting and 60 mimutes were in groupⅡ-A,patients with abnormal values at fasting and 120 mimutes were in groupⅡ-B,patients with abnormal values at 60 mimutes and 120 mimutes were in groupⅡ-C);Three abnormal blood glucose of OGTT result were in GroupⅢ.The clinical data and pregnancy outcome of pregnant women with GDM were retrospectively analyzed.RESULTS(1)The pregnancies in groupsⅡandⅢwere more than those in groupⅠ(t=8.601,7.491,P<0.05),and the incidence of adverse pregnancy history in groupⅢwas higher than that in groupⅠ(χ^(2)=9.608,P<0.05);(2)The incidence of hypertension in groupⅢwas higher than that of groupsⅠandⅡ(χ^(2)=11.483,6.757,P<0.05),the incidence of intrahepatic cholestasis in pregnancy(ICP)in groupⅢwas higher than that of groupⅠ(χ^(2)=5.106,7.163,P<0.05);(3)The incidence of hypertension during pregnancy in pregnant women in groupⅠ-A was higher than that in groupsⅠ-B andⅠ-C(χ^(2)=9.452,P<0.05),and the incidence of macrosomia in groupsⅡ-A andⅡ-B was higher than that in GroupⅡ-C(χ^(2)=7.702,P<0.05).CONCLUSION The pregnancies complicated of pregnant women with more abnormal blood glucose increased more adverse outcomes.Clinical treatment should be classified based on abnormal blood glucose according to OGTT.
作者
张玲玉
张命金
成晓燕
刘伟玲
ZHANG Ling-yu;ZHANG Ming-jin;CHENG Xiao-yan;LIU Wei-ling(Nantong Maternal and Child Health Hospital,Nantong,Jiangsu,226018,China)
出处
《中国初级卫生保健》
2022年第2期57-60,共4页
Chinese Primary Health Care
