妊娠合并糖代谢异常并发先兆子痫对母儿结局影响的分析

目的 :探讨妊娠合并糖代谢异常并发先兆子痫母、儿的结局。方法 :收集1981至 2 0 0 3年糖代谢异常孕妇 12 0 2例的临床资料 ,其中 15 1例孕妇并发先兆子痫 ,按照有无先兆子痫的发生将孕妇分为先兆子痫组 (Ⅰ组 )和非先兆子痫组 (Ⅱ组 )。回顾分析比较两组孕妇、新生儿的结局。结果 :(1)I组孕妇早产、羊水过多、酮症、手术产的发生率明显高于II组 ,发生率分别为 2 1.2 %vs 6 .0 %、13.9%vs 6 .2 %、15 .2 %vs 7.4 %、71.5 %vs6 0 .7% (P <0 .0 1) ;两组孕妇胎死宫内、胎儿窘迫、宫内感染、产后出血的发生率比较 ,差异无统计学意义 (P >0 .0 5 ) ;(2 )I组与II组的新生儿结局比较 :两组新生儿患病率有明显差异 (P <0 .0 5 ) ,新生儿窒息、畸形、红细胞增多症、低血糖和高胆红素血症发生率分别为12 .0 %vs 3.9%、7.3%vs 3.1%、8.7%vs 2 .2 %、15 .3vs 5 .7%和 18.0 %vs 12 .3% ;两组大于胎龄儿和小于胎龄儿发生率分别为 17.2 %vs 11.3%、10 .6 %vs 1.9% ;新生儿转科(41.0 %vs 19.6 % ) ,差异有显著性 (P <0 .0 5 ) ;新生儿呼吸窘迫综合征 (NRDS)及围产儿死亡的发生率两组无统计学差异 (P >0 .0 5 )。结论 :妊娠合并糖代谢异常的孕妇一旦并发先兆子痫将增加糖代谢异常孕妇的并发症及新生儿的患病率。

Maternal and fetal outcomes complicated pre-eclampsia in pregnant women with abnormal glucose metabolism

Objective:To investigate the maternal and fetal o utcomes in pre-eclampsia women with abnormal glucose metabolism during pregnanc y.Methods:A retrospective study was conducted on 1202 pregnan t women with abnormal glucose metabolism between 1981～2003. All women were divi ded into 2 groups:group I included 151 women with pre-eclampsia; group II we re 1051 women without pre-eclampsia.Results:(1)The incide nce of preterm birth, polyhydroamnios, ketonemia and operative deli very in group I was significantly higher than that of group II (21.2% vs 6.0%, 13.9% vs 6.2%, 15.2% vs 7.4% and 71.5% vs 60.7%,P<0.01). No difference was sh own betw een the two groups in the rate of fetal demise, fetal distress, i ntrauterine infection and postpartum hemorrhage (P>0.05). (2) The neonatal morbidity in group I was significantly higher than that of group II including ne onatal asphyxia, deformity, polyerythromy,hypoglycemia and hyperbilirubinemia (1 2.0% vs 3.9%, 7.3% vs 3.1%, 8.7% vs 2.2%, 15.3% vs 5.7% and 18.0% vs 12 .3%, P<0.05).The rate of LGA and SGA was 17.2% vs 11.3% and 10.6% vs 1.9% ( P<0.05) and the rate of transferring to NICU was 41.0% v s 1 9.6% (P<0.05). The incidence of NRDS and perinatal mortality wa s simila r between the two groups (P>0.05).Conclusions:The complications and neonatal morbidity would be increased in women with abno rmal glucose metabolism in pregnancy when complicated with pre-eclampsia.