妊娠期糖尿病与母婴分娩结局的临床分析

发布时间：2018-05-19 14:50

  本文选题：妊娠期糖尿病 + IADPSG标准　； 参考：《广西医科大学》2015年硕士论文

【摘要】：目的探讨妊娠期糖尿病与非糖尿病母儿的分娩结局及相关影响因素。方法回顾分析2012年10月-2013年10月在我院产科住院行剖宫产或自然分娩的并且在我院进行孕期产检的妊娠期糖尿病产妇的临床资料,随机选取同期住院分娩的非糖尿病产妇作为对照组,比较两组产妇一般情况、FBG、 75g-OGTT(1hPG、2hPG)、产前BMI及产妇、新生儿分娩后并发症差异,回归分析引起差异的因素,并通过ROC曲线寻找预测切点。结果GDM组185例,对照组196例。GDM组产妇产前BMI、妊娠期高血压发生率、剖宫产率、住院时间明显高于对照组(P0.05), GDM组新生儿分娩孕周小于对照组(P0.01),新生儿发生多个分娩并发症的风险、转新生儿科治疗率明显高于对照组(P0.01)。OGTT 2hPG以及分娩孕周对新生儿是否发生多个分娩并发症具有预测价值,相应的诊断切点为7.84mmol/L(曲线下面积为0.613,95% CI：0.552-0.674,P=0.000)和37周(曲线下面积为0.649,95% CI:0.590-0.708, P=0.000)。Logistic多因素分析提示OGTT 2hPG≥7.84mmol/L(OR值1.899,95%CI为1.158-3.112,p=0.011)、分娩孕周≤37周(OR值3.699,95%CI为2.019-6.778,p=0.000)是胎儿／新生儿发生2个以上分娩相关并发症的危险因素。结论妊娠期糖尿病增加母婴不良妊娠结局的发生率；妊娠中晚孕OGTT2hPG≥7.84mmol/L使得胎儿／新生儿发生多个分娩相关并发症的风险增加1.899倍,分娩孕周≤37周使得胎儿／新生儿发生2个以上分娩相关并发症的风险增加3.699倍；OGTT 2hPG≥7.84mmol/L及分娩孕周≤37周可能对预测新生儿发生多个分娩相关并发症具有一定的预测价值。
[Abstract]:Objective to investigate the outcome and related factors of gestational diabetes mellitus (GDM) and non-diabetic mothers and infants. Methods from October 2012 to October 2013, the clinical data of pregnant women with gestational diabetes mellitus (GDM) who were hospitalized in our hospital by cesarean section or natural delivery and who underwent prenatal examination in our hospital were analyzed retrospectively. Non-diabetic parturients who were born in hospital at the same time were randomly selected as the control group. The general conditions of the two groups were compared: FBG, 75g-OGTT1hPG2hPGG, prenatal BMI and parturient, the difference of neonatal complications after delivery, and the factors that caused the difference by regression analysis. The predicted tangent point is found by ROC curve. Results there were 185 cases in GDM group and 196 cases in control group. The incidence of pregnancy-induced hypertension, the rate of cesarean section and the hospitalization time were significantly higher than those in control group (P 0.05). The gestational weeks of newborn in GDM group were lower than that in control group (P 0.01), and the risk of multiple complications occurred in neonates. The rate of conversion to neonatal treatment was significantly higher than that of control group (P 0.01). OGTT 2hPG and gestational weeks of delivery had predictive value for the occurrence of multiple delivery complications in neonates. The corresponding diagnostic cutoff points were 7.84 mmol / L (the area under the curve was 0.61395% CI: 0.552-0.674P0.000) and 37 weeks (the area under the curve was 0.64995% CI: 0.590-0.708). P=0.000).Logistic multivariate analysis showed that OGTT 2hPG 鈮，

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