妊娠期糖代谢异常对胎儿体质量及新生儿并发症发生率的影响

目的 探讨妊娠期糖耐量异常对胎儿体质量及新生儿并发症发生率的影响.方法 对2502例孕妇进行口服50 g葡萄糖筛查试验（GCT）,对156例异常者再行75 g葡萄糖耐量试验（OGTT）,确诊妊娠期糖尿病（GDM） 86例,妊娠糖耐量受损（GIGT） 70例,与对照组300例比较,分别比较胎儿出生体质量、新生儿并发症的发生率.结果 GIGT及GDM组的胎儿体质量大于胎龄儿及巨大儿出生率明显高于对照组、适于胎龄儿出生率明显低于对照组,差别有统计学意义（P＜0.01）;小于胎龄儿出生率亦高于对照组（P＜0.05）;GIGT及GDM组孕妇所生新生儿在低血糖、高胆红素血症及产伤发病率明显高于对照组,差异有统计学意义（P＜0.01）;并发早产、窒息的发病率高于对照组,差异有统计学意义（P＜0.05）.结论 在临床中非常有必要对所有孕妇进行系统、正规的糖代谢异常检测及确诊后应规范治疗、监测;对所有糖代谢异常孕妇分娩的新生儿及时监测血糖、关注并发症的的发生,及时给予干预.

Effects of abnormal glucose metabolism during pregnancy on fetal body mass and incidence of neonatal complications

Objective To investigate the effects of abnormal glucose tolerance during pregnancy on the incidence of fetal body mass and neonatal complications.Methods Oral 50g glucose challenge test （GCT）was done in 2502 cases of pregnant women,156 cases of abnormal 75g oral glucose tolerance retest （OGTT）,diagnosed with gestational diabetes mellitus （GDM） in 86 cases,gestational impaired glucose tolerance （GIGT） in 70 cases,and 300 cases of the control group,then we compared the incidence of fetal students body mass,neonatal complications.Results Fetal body mass of GIGT and GDM groups was large for gestational age and fetal macrosomia,significantly higher than that of the control group,the appropriate for gestational age at birth rate was significantly lower than that of the control group,there was statistical significant difference （P ＜ 0.01）; small for gestational age infants birth rate was also higher than that of the control group （P ＜ 0.05）; GIGT and GDM groups of pregnant women neonatal hypoglycemia,hyperbilirubinemia and in birth injury incidence was significantly higher than that in the control group,there was significant difference （P ＜ 0.01）; concurrent premature,asphyxia morbidity were igher than those of the control group,there was statistical significant difference （P ＜ 0.05）.Conclusion In clinical practice it is very necessary to detect glucose metabolism with anomaly detection and diagnosis system for all pregnant women,normal glucose metabolism treatment should be standardized and monitored; neonates delivered by all pregnant women with abnormal glucose metabolism should be given timely monitoring of blood glucose,complications and timely intervention.