GDM孕妇孕期体重增幅与围产结局的关系研究
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摘要
目的探讨妊娠期糖尿病(GDM)孕妇孕期体重增幅与围产结局的关系。方法选择2017年1至12月在北京友谊医院门诊产检、住院分娩的GDM孕妇共108例,计算孕前身体质量指数(BMI),记录整个孕期体重增加幅度,并根据体重增加幅度进行分组,其中孕期体重增幅过多组38例,增幅合适组42例,增幅不足组28例,比较并分析三组的围产结局。结果孕期体重增幅过多组的GDM孕妇妊娠期高血压疾病的发生率(21.1%)明显高于增幅合适组(7.1%)及增幅不足组(3.6%),差异有统计学意义(χ~2=6.084,P<0.05)。三组的产后出血、妊娠期贫血、早产及胎膜早破的发生率差异均无统计学意义(均P>0.05)。孕期体重增幅过多组的巨大儿、剖宫产的发生率(21.1%、36.8%)均显著高于增幅合适组(4.8%、21.4%)及增幅不足组(3.6%、10.7%),差异均有统计学意义(χ~2值分别为7.595、6.284,均P<0.05)。三组的胎儿窘迫、胎儿畸形、新生儿低血糖及新生儿窒息发生率比较差异均无统计学意义(均P>0.05)。结论 GDM孕妇属于高危妊娠,产科医生应加强对其孕期的体重管理,以减少围产期并发症的发生。
Objective To investigate the relationship between perinatal outcomes and gestational weight gain in gestational diabetes mellitus(GDM) cases. Methods A total of 108 cases of GDM in-patients were included in this study who delivered in the period of January to December 2017 in Beijing Friendship Hospital. Body mass index(BMI) was calculated and the weight increasing was recorded throughout the pregnancy. Based on the body weight increasing, 38 cases was grouped into excessive weight gain group, 42 cases in suitable weight gain group, and 28 cases in insufficient weight gain group. Their perinatal outcomes were compared. Results In excessive weight gain group, the incidence of gestational hypertension was 21.1%, which was higher than that in suitable weight gain group(7.1%) and insufficient weight gain group(3.6%) with significant difference(χ~2=6.084, P<0.05). Among three groups, no significant differences were found in the incidence of postpartum hemorrhage, anemia, preterm labor and premature rupture of membranes(all P>0.05). In excessive weight gain group, the incidence rates of macrosomia and cesarean section(21.1%, 36.8%) was significantly higher than those in suitable weight gain group(4.8%, 21.4%) and insufficient weight gain group(3.6%, 10.7%) with statistical significance(χ~2 value was 7.595 and 6.284, respectively, both P<0.05). Among three groups, no significant differences were found in the incidence of fetal distress, fetal deformity, neonatal hypoglycemia and neonatal asphyxia(all P>0.05). Conclusion GDM pregnancy is high risk. Patients' weight should be closely monitored during pregnancy to reduce the incidence of perinatal complications.
Objective To investigate the relationship between perinatal outcomes and gestational weight gain in gestational diabetes mellitus(GDM) cases. Methods A total of 108 cases of GDM in-patients were included in this study who delivered in the period of January to December 2017 in Beijing Friendship Hospital. Body mass index(BMI) was calculated and the weight increasing was recorded throughout the pregnancy. Based on the body weight increasing, 38 cases was grouped into excessive weight gain group, 42 cases in suitable weight gain group, and 28 cases in insufficient weight gain group. Their perinatal outcomes were compared. Results In excessive weight gain group, the incidence of gestational hypertension was 21.1%, which was higher than that in suitable weight gain group(7.1%) and insufficient weight gain group(3.6%) with significant difference(χ~2=6.084, P<0.05). Among three groups, no significant differences were found in the incidence of postpartum hemorrhage, anemia, preterm labor and premature rupture of membranes(all P>0.05). In excessive weight gain group, the incidence rates of macrosomia and cesarean section(21.1%, 36.8%) was significantly higher than those in suitable weight gain group(4.8%, 21.4%) and insufficient weight gain group(3.6%, 10.7%) with statistical significance(χ~2 value was 7.595 and 6.284, respectively, both P<0.05). Among three groups, no significant differences were found in the incidence of fetal distress, fetal deformity, neonatal hypoglycemia and neonatal asphyxia(all P>0.05). Conclusion GDM pregnancy is high risk. Patients' weight should be closely monitored during pregnancy to reduce the incidence of perinatal complications.
引文
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[6]Benhalima K,Robyns K,Van Crombrugge P,et al.Differences in pregnancy outcomes and characteristics between insulin-and diet-treated women with gestational diabetes[J].BMC Pregnancy Childbirth,2015,15:271.
[2]Yang H X.Diagnostic criteria for gestational diabetes mellitus(WS 331-2011)[J].Chin Med J (Engl),2012,125(7):1212-1213.
[3]Lambrinoudaki I,Vlachou S A,Creatsas G.Genetics in gestational diabetes mellitus:association with incidence,severity,pregnancy outcome and response to treatment[J].Curr Diabetes Rev,2010,6(6):393-399.
[4]Vrachnis N,Belitsos P,Sifakis S,et al.Role of adipokines and other inflammatory mediators in gestational diabetes mellitus and previous gestational diabetes mellitus[J].Int J Endocrinol,2012,2012(2):1-12.
[5]侯磊,王欣,邹丽颖,等.1268例妊娠期糖尿病产妇围产结局分析[J].中国临床医生杂志,2016,44(4):38-40.
[6]Benhalima K,Robyns K,Van Crombrugge P,et al.Differences in pregnancy outcomes and characteristics between insulin-and diet-treated women with gestational diabetes[J].BMC Pregnancy Childbirth,2015,15:271.