文章摘要
王 芸,石中华.妊娠期糖尿病的两种不同诊断标准对围产期母婴结局的影响[J].南京医科大学学报,2013,(11):1576~1579
妊娠期糖尿病的两种不同诊断标准对围产期母婴结局的影响
Influences of two different diagnostic criteria of Gestational Diabetes Mellitus on maternal and perinatal outcome
投稿时间:2013-05-27  
DOI:10.7655/NYDXBNS20131122
中文关键词: 妊娠期糖尿病  诊断标准  母婴结局
英文关键词: GDM,diagnostic criteria,maternal and perinatal outcome
基金项目:国家自然科学基金(81000258,81100436);江苏省自然科学基金(BK2010586);南京市科技发展计划项目(201104014)
作者单位
王 芸 南京医科大学附属南京市妇幼保健院产科,江苏 南京 210004 
石中华 南京医科大学附属南京市妇幼保健院产科,江苏 南京 210004 
摘要点击次数: 1508
全文下载次数: 955
中文摘要:
      目的:比较两种不同的妊娠期糖尿病(gestational diabetes mellitus,GDM)诊断标准对GDM检出率和围产期母婴结局的影响。方法:选择在南京市妇幼保健院进行糖筛查及分娩的孕产妇为研究对象,将其分为两组。分别按照我国第7 版《妇产科学》GDM诊断标准及国际糖尿病与妊娠研究组(International Association of Diabetes and Pregnancy Study Groups,IADPSG)制定的GDM诊断标准进行诊断,比较两组孕妇GDM检出率?分娩方式?常见妊娠期并发症及新生儿并发症发生率的差异。结果:IADPSG诊断标准组GDM检出率明显高于《妇产科学》诊断标准组(P < 0.05);IADPSG诊断标准组有指征剖宫产率显著低于《妇产科学》诊断标准组(P < 0.05);IADPSG诊断标准组羊水过多?胎膜早破等并发症的发病率显著低于《妇产科学》诊断标准组(P < 0.05),而妊娠期高血压疾病?糖尿病酮症酸中毒?胎儿窘迫及产后出血发生率两组无显著差异(P > 0.05);IADPSG诊断标准组新生儿发生巨大儿?新生儿低血糖?新生儿呼吸窘迫综合征等并发症的发病率显著低于《妇产科学》诊断标准组(P < 0.05),而早产?低体重儿?新生儿窒息?新生儿黄疸?新生儿高胆红素血症?新生儿发育畸形等发生率两组无显著差异( P > 0.05)。结论:应用IADPSG标准可以有效提高GDM检出率,显著降低羊水过多?胎膜早破?巨大儿等妊娠并发症的产生,从而降低剖宫产率,并显著降低了新生儿低血糖?新生儿呼吸窘迫综合等风险的发生,改善母婴结局。
英文摘要:
      Objective:To compare the influences of two different diagnostic criteria of Gestational Diabetes Mellitus (GDM) on detection rates and pregnancy outcomes. Methods:More than ten thousand cases of pregnant women undergoing glucose screening and delivery in Nanjing Maternal and Child Health Care Hospital were enroll in this study and divided into two groups. One group was diagnosed according to the criteria in 7th edition of “Obstetrics and Gynecology”,and the other group was diagnosed according to the criteria of International Diabetes and Pregnancy Study Group (International Association of Diabetes and Pregnancy Study Groups,the IADPSG). We compared the GDM detection rates,mode of delivery,common complications of pregnancy and neonatal complications incidence between the two groups. Results:The GDM detection rate of IADPSG group was significantly higher than that of the 7th edition of “Obstetrics and Gynecology” group (P < 0.05). The cesarean section rate of IADPSG diagnostic criteria was significantly lower than the those of 7th edition of “Obstetrics and Gynecology” group (P < 0.01). The incidences of polyhydramnios and premature rupture of membranes were significantly lower than those of the 7th edition of “Obstetrics and Gynecology” group (P < 0.05). There were no significant differences of the incidences of hypertensive disorders on pregnancy,diabetes ketoacidosis,fetal distress and postpartum hemorrhage between two groups(P > 0.05). The incidences of fetal macrosomia,neonatal hypoglycemia and neonatal respiratory distress syndrome polyhydramnios were significantly lower than those of the 7th edition of “Obstetrics and Gynecology” group (P < 0.05). There were no significant differences of the incidences of premature birth,low birth weight infants,neonatal asphyxia,neonatal jaundice,neonatal hyperbilirubinemia,neonatal developmental malformations between two groups (P > 0 05). Conclusion:The diagnosis of GDM according to the IADPSG criteria can effectively elevate the detection rate of GDM,dramatically reduce the incidences of polyhydramnios,premature rupture of membranes and fetal macrosomia,thereby reducing the rate of cesarean section,and significantly reduce neonatal hypoglycemia and newborn respiratory distress and improving maternal and neonatal outcomes.
查看全文   查看/发表评论  下载PDF阅读器