摘要
Abstract
Objective To investigate the relationship between abnormal blood glucose index and pregnancy outcomes in women with gestational diabetes mellitus (GDM).Methods Altogether 937 cases of GDM who underwent regular prenatal examination and delivered in the First People''s Hospital of Kunshan from January to December in 2016 were selected.Seventy-five gram oral glucose tolerance test (75gOGTT) was operated in 24-28 weeks.According to blood glucose of 75gOGTT at each time point, these women were separated into group A (only fasting glucose abnormal), group B (1h and/or 2h glucose abnormal but fasting glucose normal) and group C (fasting glucose abnormal and 1h and/or 2h glucose abnormal).Differences in pregnant outcomes and insulin usage rate among three groups were analyzed.To analyze relativity between abnormality of different blood glucose index and neonatal birth weight, pregnant women with simple fasting glucose abnormality were divided into fasting blood glucose group, women with 1h OGTT abnormality into OGTT1h group and women with OGTT 2h abnormality into OGTT2h group.Relativity of fasting blood glucose, OGTT1h blood glucose, OGTT2h blood glucose and neonatal birth weight were analyzed.Results In 937 pregnant women with GDM, 323 cases were in group A (34.47%), 436 cases in group B (46.53%) and 178 cases in group C (19.00%).There were significant differences in incidence of premature delivery, macrosomia and postpartum hemorrhage among group A, B and C (χ2 value was 6.72, 12.00 and 6.29, respectively, all P<0.05).Comparison between every two groups showed that incidences of premature delivery and postpartum hemorrhage in group C were significantly higher than those in group A and B (χ2 value was 4.37, 4.61, 5.78 and 4.89, respectively, all P<0.05), incidence of macrosomia in group A and C was much higher than that in group B (χ2 value was 4.75 and 11.86, respectively, both P<0.05), but there was no significant difference in macrosomia incidence between group A and C (χ2=1.99, P>0.05).There was no significant difference in premature delivery and postpartum hemorrhage between group A and B (χ2 value was 0.03 and 0.00, respectively, both P>0.05).Incidences of premature rupture of membranes, pregnancy complicated with hypothyroidism and pregnancy induced hypertension in three groups had no significant difference (χ2 value was 0.94, 0.39 and 0.56, respectively, all P>0.05).Comparison of insulin usage rate among three groups revealed that insulin usage rate in group C was statistically higher than that in group A, and that in group A was higher than in group B with statistically significant difference (χ2 value was 15.81 and 5.44, respectively, both P<0.05).Relativity comparison showed that in pregnant women diagnosed with GDM, OGTT fasting blood glucose was positively associated with neonatal birth weight and difference was statistically significant (r=0.12, P<0.05), but no obvious correlation was found between OGTT1h and OGTT2h blood glucose and neonatal birth weight (r value was 0.08 and 0.01, respectively, both P>0.05).Conclusion Incidence of adverse pregnant outcomes is increased significantly in GDM pregnant women with abnormal fasting blood glucose combined with blood glucose abnormality at one or two different time points.OGTT fasting blood glucose is of great significance for detection of GDM and prediction of neonatal birth weight.Clinical management should be classified based on OGTT abnormality status.关键词
妊娠期糖尿病/口服葡萄糖耐量试验/妊娠结局/新生儿出生体重Key words
gestational diabetes mellitus (GDM)/oral glucose tolerance test (OGTT)/pregnant outcomes/neonatal birth weight分类
医药卫生
