摘要
Abstract
Objective To evaluate the effects of glucose levels at different time points after oral glucose tolerance test ( OGTT) on the diagnosis of gestational diabetes mellitus ( GDM ) and pregnancy outcomes. Methods 516 pregnant women admitted to Department of Obstetrics in the Second Xiangya Hospital of Central South University for delivery were collected from May to September in 2015.75 g glucose OGTT was performed at 24 to 28 weeks of gestation.GDM was detected in 109 cases.According to the time points for diagnosis of GDM and excluding 13 cases with GDM diagnosed at two or more time points, the patients were divided into 3 groups: 35 cases in group diagnosed at fasting blood glucose ( group A) , 20 cases in group diagnosed at OGTT 1 h blood glucose ( group B) , 41 cases in group diagnosed at OGTT 2 h blood glucose ( group C) .Clinical data of pregnant women with GDM were retrospectively analysed, including: maternal age, pre-pregnancy body mass index ( BMI) , body mass growth during pregnancy, neonate birth weight and pregnancy outcomes ( premature rupture of membranes, macrosomia, preterm delivery, fetal distress, neonatal pathologic jaundice, gestational hypertension).Results In all 516 pregnant women, GDM was detected in 109 cases, the detection rate of GDM was 21.12%.The detection rate of GDM was 6.78%by diagnosed at fasting blood glucose.The detection rate of GDM was 3.88%by diagnosed at OGTT 1 h blood glucose. The detection rate of GDM was 7.95%by diagnosed at OGTT 2 h blood glucose.There were statistically significant difference in the detection rate of GDM according to blood glucose levels at different OGTT time points (χ2 =7.80, P=0.02).The detection rate of GDM by diagnosed at OGTT 1 h blood glucose was lower than diagnosed at fasting blood glucose and OGTT 2 h blood glucose ( P <0.01 ) . There were statistically significant difference in maternal age among the 3 groups ( P <0.05 ) . The maternal age in group A was lower than group B and group C ( P<0.05) .There were no statistically significant difference in pre-pregnancy BMI, body mass growth during pregnancy and neonate birth weight among the 3 groups (P>0.05).There was statistically significant difference in the incidence of fetal distress among the 3 groups ( P<0.05) .The incidence of fetal distress in group C was lower than group B ( P <0.01 ) . There were no statistically significant difference in premature rupture of membranes, macrosomia, preterm delivery, neonatal pathologic jaundice, gestational hypertension among the 3 groups ( P<0.05 ) .Conclusion The detection rate of GDM was 21.12%.There are some differences in the diagnosis of GDM according to blood glucose levels at different OGTT time points. The detection rate at OGTT 1 h blood glucose is lower than fasting blood glucose and OGTT 2 h blood glucose.The incidence of fetal distress is higher in group diagnosed at OGTT 1 h blood glucose.关键词
糖尿病, 妊娠/葡糖耐量试验/诊断/妊娠结局Key words
Diabetes, gestational/Glucose tolerance test/Diagnosis/Pregnancy outcome分类
医药卫生
