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目的:探讨开展妊娠期糖尿病的筛查、诊断及观察其妊娠结局。方法:对2006年1月～2007年6月在该院进行产前检查并要求住院分娩的孕妇1100例,于孕24周进行口服50g葡萄糖筛查(GCT),血糖值≥7.8mmol/L者,于次日行75g葡萄糖耐量试验(OGTT),了解GDM的发病率及高危因素,观察其妊娠结局。结果:50g葡萄糖筛查(GCT)阳性率9.8%,妊娠期糖耐量受损(GIGT)发病率4.3%,妊娠期糖尿病(GDM)发病率3.0%,有高危因素者占GDM45.5%。GIGT组及GDM组妊娠高血压疾病、胎儿宫内窘迫、羊水过多、胎膜早破、早产、产后出血及剖宫产发病率均高于对照组,有显著性差异(P<0.05);新生儿低血糖、高胆红素血症、巨大儿、新生儿窒息、NRDS与对照组比较有显著性差异(P<0.05),均有统计学意义,GIGT组与GDM组比较无显著性差异(P>0.05)。结论:应对GDM早筛查、早诊断、早治疗,可降低母婴并发症的发生,改善妊娠结局。
Objective: To investigate screening, diagnosis and observation of pregnancy outcome in gestational diabetes. Methods: From January 2006 to June 2007, 1100 pregnant women who were hospitalized for prenatal examination and hospitalized for delivery were enrolled in this study. 50g glucose screening (GCT) and blood glucose ≥7.8mmol / L , The next day 75g glucose tolerance test (OGTT), to understand the incidence of GDM and risk factors to observe the pregnancy outcome. Results: The positive rate of GCT in 50g was 9.8%, the incidence of GIGT in pregnancy was 4.3%, the incidence of gestational diabetes mellitus (GDM) was 3.0%, and the risk factors for GDM were 45.5%. The incidences of pregnancy-induced hypertension, fetal distress, polyhydramnios, premature rupture of membranes, preterm birth, postpartum hemorrhage and cesarean section in GIGT group and GDM group were significantly higher than those in control group (P <0.05). Neonatal hypoglycemia, hyperbilirubinemia, macrosomia, neonatal asphyxia, NRDS compared with the control group were significantly different (P <0.05), were statistically significant, GIGT group and GDM group no significant difference (P> 0.05). Conclusion: Early screening, early diagnosis and early treatment of GDM should reduce the incidence of maternal and infant complications and improve pregnancy outcome.