摘要
目的研究妊娠糖尿病(GDM)合并绒毛膜血管病对血糖控制与妊娠结局的影响。方法188例妊娠糖尿病孕妇,根据胎盘病理分为绒毛膜血管病组(74例,胎盘病理提示绒毛膜血管病)及非绒毛膜血管病组(114例,胎盘病理未提示绒毛膜血管病)。分析比较两组孕妇的临床资料、血糖控制水平、妊娠并发症及新生儿情况。结果两组孕妇年龄、孕前体质量指数(BMI)、孕次、产次比较,差异无统计学意义(P>0.05)。两组孕妇孕早期空腹血糖(FPG)及口服葡萄糖耐量试验(OGTT)1 h、2 h血糖水平比较,差异无统计学意义(P>0.05);绒毛膜血管病组孕妇孕晚期糖化血红蛋白(HbA1c)(6.46±0.48)%、FPG(6.19±0.94)mmol/L均高于非绒毛膜血管病组的(5.18±0.37)%、(4.65±0.53)mmol/L,差异有统计学意义(P<0.05)。两组孕妇妊娠肝内胆汁淤积症(ICP)、产后出血发生率比较,差异无统计学意义(P>0.05);绒毛膜血管病组孕妇妊娠期高血压、绒毛膜羊膜炎、贫血、胎膜早破、胎盘早剥、羊水过少发生率分别为27.03%、14.86%、51.35%、32.43%、6.76%、13.51%,均高于非绒毛膜血管病组的14.04%、4.39%、17.54%、17.54%、0.88%、4.39%,差异有统计学意义(P<0.05)。两组新生儿出生体重及早产发生率比较,差异无统计学意义(P>0.05);绒毛膜血管病组新生儿Apgar评分(9.11±0.40)分低于非绒毛膜血管病组的(9.62±0.36)分,重症监护病房(NICU)入住率59.46%、窒息发生率9.46%及胎儿宫内窘迫发生率24.32%、胎儿生长受限(FGR)发生率10.81%均高于非绒毛膜血管病组42.11%、1.75%、8.77%、2.63%,差异有统计学意义(P<0.05)。结论妊娠糖尿病合并绒毛膜血管病更容易发生不良妊娠结局,针对妊娠糖尿病人群需严格血糖调控,以降低孕期罹患绒毛膜血管病的风险,改善妊娠不良结局。
Objective To study the influence of gestational diabetes mellitus(GDM)with chorangiosis on blood glucose control and pregnancy outcome.Methods According to placental pathology,188 women with gestational diabetes mellitus were divided into chorangiosis group(74 cases,placental pathology suggested chorangiosis)and non-chorangiosis group(114 cases,placental pathology did not suggest chorangiosis).The clinical data,blood glucose control level,pregnancy complications and neonatal status of the two groups were analyzed and compared.Results There was no statistically significant difference between the two groups in terms of age,pre-pregnancy body mass index(BMI),gravidity and parity(P>0.05).There was no statistically significant difference in fasting plasma glucose(FPG)and 1-and 2-h oral glucose tolerance test(OGTT)between the two groups in early pregnancy(P>0.05).The HbA1c(6.46±0.48)%and FPG(6.19±0.94)mmol/L in late pregnancy in chorangiosis group were higher than(5.18±0.37)%and(4.65±0.53)mmol/L in non-chorangiosis group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of intrahepatic cholestasis of pregnancy(ICP)and postpartum hemorrhage between the two groups of pregnant women(P>0.05).The incidence of gestational hypertension,chorioamnionitis,anemia,premature rupture of membranes,placental abruption,and oligohydramnios were 27.03%,14.86%,51.35%,32.43%,6.76%,and 13.51%in the chorangiosis group,which were higher than 14.04%,4.39%,17.54%,17.54%,0.88%,and 4.39%in the non-chorangiosis group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in birth weight and incidence of preterm birth between the two groups(P>0.05).The neonatal Apgar score(9.11±0.40)points in the chorangiosis group was lower than(9.62±0.36)points in the non-chorangiosis group;the chorangiosis group had incidence of neonatal intensive care unit(NICU)of 59.46%,incidence of asphyxia of 9.46%and incidence of intrauterine distress of 24.32%,and the incidence of fetal growth restriction(FGR)of 10.81%,which were higher than 42.11%,1.75%,8.77%,and 2.63%in the non-chorangiosis group;the differences were statistically significant(P<0.05).Conclusion Gestational diabetes mellitus combined with chorangiosis is more likely to have adverse pregnancy outcomes,and strict glucose control is needed for people with gestational diabetes mellitus to reduce the risk of chorangiosis during pregnancy and improve adverse pregnancy outcomes.
作者
刘英
冷芹
于威威
吴娟
LIU Ying;LENG Qin;YU Wei-wei(Department of Obstetrics,Xiamen Maternal and Child Health Hospital,Xiamen 361000,China)
出处
《中国现代药物应用》
2023年第4期44-47,共4页
Chinese Journal of Modern Drug Application
关键词
妊娠糖尿病
绒毛膜血管病
胎盘病理
妊娠结局
空腹血糖
Gestational diabetes mellitus
Chorangiosis
Placental pathology
Pregnancy outcome
Fasting blood glucose
