论文部分内容阅读
目的评价妊娠期糖尿病(GDM)的严重程度与子前期是否存在关联,良好的血糖控制能否降低子前期发生率。方法回顾性分析2002-2006年在南京市确诊的GDM病例1518例,其中伴子前期159例。用75g葡萄糖耐量试验(OGTT)中不同的空腹血糖值以0.3mmol/L为间隔单位进行GDM分组,分析其子前期的发生情况,以糖化血红蛋白值作为评判妊娠最后1～2个月血糖控制情况。结果在GDM患者中,子前期的发生率是10.5%(159/1518);GDM伴子前期组孕前的体重指数(BMI)和孕期体重增长与GDM不伴子前期组相比,差异有统计学意义(P<0.01);随着空腹血糖值的上升,子前期发生率呈上升趋势;以空腹血糖值5.6mmol/L为界分为两组,它的比值比(OR)为2.05和95%可信区间(CI)为1.34～3.12;GDM伴子前期组分娩前糖化血红蛋白值(HbA1c)明显增高(P<0.01)。结论子前期的发生率与GDM的严重程度有关;孕前高BMI和孕期体重增长过快是GDM伴子前期发生的独立因素;孕期良好的血糖控制可以降低子前期的发生率。
Objective To evaluate the relationship between the severity of gestational diabetes mellitus (GDM) and the preeclampsia, and whether good glycemic control can reduce the incidence of preeclampsia. Methods Retrospective analysis of 1518 cases of GDM diagnosed in Nanjing from 2002 to 2006, including 159 cases of pre-emia. GDM was divided into groups according to different fasting blood glucose levels in 75g glucose tolerance test (OGTT) at intervals of 0.3mmol / L, and the incidence of preeclampsia was analyzed. The level of HbA1c was used to evaluate the glycemic control in the last 1 ~ 2 months of pregnancy Happening. Results The incidence of preeclampsia in GDM patients was 10.5% (159/1518). The body mass index (BMI) and preterm pregnancy weight gain in GDM with pre-conception group were significantly higher than those in pre-GDM group (P <0.01). With the increase of fasting blood glucose, the incidence of preeclampsia was on the rise. Based on the fasting blood glucose of 5.6 mmol / L, the odds ratio (OR) was 2.05 and 95% confidence interval (CI) ranged from 1.34 to 3.12. Pre-delivery glycated hemoglobin (HbA1c) was significantly increased in pre-delivery GDM mice (P <0.01). Conclusions The incidence of preeclampsia is related to the severity of GDM. Pre-pregnancy high BMI and premature weight gain during pregnancy are independent factors in pre-eclampsia. Good prenatal glycemic control may reduce the incidence of preeclampsia.