摘要
目的 通过对 85 0例糖筛查异常孕妇口服 75 g葡萄糖耐量试验 (OGTT)结果和妊娠结局的分析 ,了解妊娠期糖代谢异常不同诊断标准与妊娠结局的关系。 方法 对 2 0 0 1年 1月 1日至 2 0 0 3年12月 3 1日在我院分娩、5 0 g糖筛查异常、OGTT结果不符合我院使用的Fernando标准、未诊断妊娠期糖尿病 (GDM )和糖耐量受损 (GIGT)的 85 0例孕妇进行回顾性研究。将 85 0例孕妇分成两组 :符合董志光等人妊娠期糖尿病 (GDM )和糖耐量受损标准组 (第一组 )及不符合组 (第二组 )。 结果 妊娠期糖代谢异常发生率为 2 3 .76% (2 0 2例 ) ,以董志光诊断标准 ,其中GDM 3 7例 ,占 4.3 5 % ,IGT 165例 ,占 19.41%。新生儿平均出生体重为 (3 461.4± 475 .9)g ,高于不符合组 [(3 40 7.8± 43 8.4) g ,P <0 .0 1]。巨大儿发生率虽高一些 ,但无统计学差异。剖宫产率两组间也无差异。妊娠期合并症如妊娠高血压综合征、胎膜早破和早产的发生率 ,以及新生儿低血糖、黄疸和低出生体重儿的发生率两组间均无差异。 结论 按Fernando标准 ,糖筛查异常人群中将有 2 3 .76%的糖代谢异常者被漏诊 ,但发生妊娠高血压综合征、胎膜早破、早产、剖宫产、新生儿低血糖、黄疸和低出生体重儿的危险性并无明显增加。如按董志光等人的标准 ,将?
Objective To evaluate the influence of different diagnostic criteria of gestational diabetes mellitus(GDM) using oral glucose tolerance test(OGTT) on pregnant outcome. Methods A retrospective study of women who delivered at Peking University First Hospital from Jan 1, 2001 to Dec 31,2003 was conducted. All women with abnormal 50 g oral glucose screening test received 75 g OGTT. Totally, there were 850 cases not being diagnosed as GDM or GIGT according to Fernando′s criteria and these women were divided to two groups according to Zhi guang DONG′s criteria: group Ⅰ included those who meet the criteria of GDM and GIGT and group Ⅱ included those who did not. Results The rate of abnormal OGTT was 23.76% (GDM 4.35%, GIGT 19.41,37 vs 165 cases). The average birth weight of group Ⅰ was significantly higher than that of group Ⅱ [(3461.4±475.9)g vs (3407.8±438.4) g, P <0.01]. There was no difference in the incidence of cesarean section, macrosomia, pregnancy induced hypertension, premature rupture of fetal membranes, preterm delivery, neonatal hypoglycemia, jaundice and low birth weight between the two groups. Conclusions 23.76% of women with GDM or GIGT would be lost when applying Fernando′s OGTT criteria, but the risks of dystocia, maternal and neonate complications do not increase. If the Dong′s criteria is applied, these group of women will be treated thus result in concerns psychologically and economically.
出处
《中华围产医学杂志》
CAS
2005年第1期1-4,共4页
Chinese Journal of Perinatal Medicine
