妊娠期糖尿病与子痫前期发病的关系及对分娩结局的影响

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目的分析妊娠期糖尿病(GDM)与子痫前期(PE)发病的关系及对分娩结局的影响。方法回顾分析1154例孕妇的病例资料,收集孕妇的一般资料、分娩结局资料,将孕妇是否为妊娠期糖尿病分为GDM组和非GDM组,比较两组患者子痫前期发生情况,分析单纯GDM组、单纯PE组、GDM合并PE组的分娩结局,纳入50例正常孕妇进行分娩结局分析,作为对照研究。结果 1154例孕妇中共有GDM孕妇43例,发病率为3.73%;PE孕妇55例,发病率为4.77%。GDM组PE总发病率为11.63%,明显高于非GDM组的4.50%,差异有统计学意义(P<0.05)。单纯PE组、GDM合并PE组的1 min Apgar评分、5 min Apgar评分、出生体质量明显低于单纯GDM组和正常孕妇组,差异有统计学意义(P<0.05);单纯PE组、GDM合并PE组的转入新生儿重症监护病房(NICU)比例明显高于单纯GDM组和正常孕妇组,差异有统计学意义(P<0.05);单纯GDM组巨大儿比例明显高于单纯PE组和正常孕妇组,差异有统计学意义(P<0.05);GDM合并PE组小于胎龄儿比例、早产率明显高于单纯GDM组、单纯PE组、正常孕妇组,差异有统计学意义(P<0.05)。结论妊娠期糖尿病孕妇合并子痫前期风险显著增加,子痫前期可对分娩结局产生不良影响,应加强孕期管理,积极防治,改善母儿预后。 Objective To analyze the relationship between gestational diabetes mellitus (GDM) and preeclampsia (PE) and the impact on delivery outcome. Methods A total of 1154 cases of pregnant women were retrospectively analyzed. The general data of pregnant women, delivery outcome data were collected. The pregnant women were divided into GDM group and non-GDM group for gestational diabetes. The incidence of preeclampsia was compared between the two groups. , Simple PE group, GDM combined with PE group of delivery outcomes, 50 cases of normal pregnant women included in the delivery outcome analysis, as a control study. Results A total of 1154 GDM pregnant women in 43 cases, the incidence was 3.73%; PE pregnant women in 55 cases, the incidence was 4.77%. The overall incidence of PE in GDM group was 11.63%, which was significantly higher than that in non-GDM group (4.50%, P <0.05). Compared with pure GDM group and normal pregnant women group, the PEI group, GDM combined with PE group 1 min Apgar score, Apgar score 5 min, birth weight was significantly lower (P <0.05); simple PE group, GDM combined (P <0.05). The proportion of macrosomia in PE group was significantly higher than that in simple PE group and normal control group (P <0.05). The proportion of macrosomia in neonatal intensive care unit (NICU) in PE group was significantly higher than that in simple GDM group and normal pregnant women group Pregnant women group, the difference was statistically significant (P <0.05); GDM with PE group less than the proportion of gestational age children, the preterm birth rate was significantly higher than the simple GDM group, simple PE group, normal pregnant women group, the difference was statistically significant (P <0.05 ). Conclusion The risk of preeclampsia in pregnant women with gestational diabetes mellitus is significantly increased. Preeclampsia may have an adverse effect on delivery outcomes. Pregnancy management should be strengthened, and prevention and treatment should be strengthened to improve the prognosis of pregnant women.
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