[1]王 珊,高坚蓉,李 霞.妊娠期糖尿病并发胎儿生长受限106例临床研究[J].陕西医学杂志,2023,52(1):67-70.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.015]
　WANG Shan,GAO Jianrong,LI Xia.Clinical study of 106 cases of fetal growth restriction in gestational diabetes mellitus[J].,2023,52(1):67-70.[doi:DOI:10.3969/j.issn.1000-7377.2023.01.015]
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妊娠期糖尿病并发胎儿生长受限106例临床研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年1期
页码:
67-70
栏目:
临床研究
出版日期:
2023-01-05

文章信息/Info

Title:
Clinical study of 106 cases of fetal growth restriction in gestational diabetes mellitus
作者:
王 珊; 高坚蓉; 李 霞
(西安市人民医院 西安市第四医院妇产科,陕西 西安 710004)
Author(s):
WANG Shan; GAO Jianrong; LI Xia
(Department of Obstetrics and Gynecology,Xi'an People's Hospital,Xi'an 710004,China)
关键词:
妊娠期糖尿病;  胎儿生长受限;  危险因素;  孕妇;  新生儿;  并发症
Keywords:
Gestational diabetes mellitus;  Fetal growth restriction;  Risk factor;  Pregnant women;  Neonates;  Complication
分类号:
R 714.2
DOI:
DOI:10.3969/j.issn.1000-7377.2023.01.015
文献标志码:
A
摘要:
目的:探究妊娠期糖尿病(GDM)并发胎儿生长受限(FGR)的临床特征。方法:选择106例GDM合并FGR孕妇为观察组研究对象,106例单纯GDM为对照组。统计比较两组孕妇妊娠期情况和新生儿并发症发生情况,Logistic回归分析法分析影响GDM孕妇并发FGR的危险因素。结果:与对照组比,观察组孕妇年龄和高龄者、妊娠前超重/肥胖者、血糖控制不满意者占比明显增大,GDM发病孕周减小(均P<0.05),孕妇并发妊娠期高血压、先兆性子痫、羊水量减少、胎儿窘迫及胎儿脐动脉血S/D值反复异常发生率显著增大,S/D值首次异常时间提早,孕28～32周血清HbA1c水平升高(均P<0.05)。多元Logistic回归分析显示,GDM发病孕周是其并发FGR的保护性因素,血糖控制不满意、并发妊娠期高血压、并发先兆性子痫、羊水过少、S/D值反复异常和孕28～30周血清HbA1c水平均是其并发FGR的危险因素(均P<0.05)。观察组37周前终止妊娠率、新生儿并发红细胞增多症、窒息和极低体重儿率显著高于对照组(均P<0.05)。结论:GDM发病孕周早、血糖控制不满意、并发妊娠期高血压/先兆性子痫、羊水量减少、脐动脉血S/D值反复异常及孕28～30周HbA1c水平升高均会增加FGR发生风险,且GDM并发FGR会增大新生儿并发症发生风险。
Abstract:
Objective:To explore the clinical features of gestational diabetes mellitus(GDM)complicated with fetal growth restriction(FGR).Methods:A total of 106 pregnant women with GDM and FGR were selected as the observation group,and 106 pregnant women with pure GDM were selected as the control group.Pregnancy and neonatal complications were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for FGR in pregnant women with GDM.Results:Compared with the control group,the proportion of pregnant women in the observation group was significantly increased in terms of age and advanced age,pre-pregnancy overweight/obesity,and those with unsatisfactory blood sugar control,with a decrease in pregnancy week of onset of GDM(all P<0.05),and the incidence of complicated gestational hypertension,preeclampsia,decreased amniotic fluid volume,fetal distress and repeated abnormality of fetal umbilical artery blood S/D value was significantly increased,the first abnormal time of S/D value was earlier,and the serum HbA1c level at 28 to 32 weeks of gestation increased(all P<0.05).Logistic regression analysis showed that gestational age at onset of GDM was protective factor for FGR,and unsatisfactory blood sugar control,gestational hypertension,preeclampsia,oligohydramnios,repeated abnormal S/D value and serum HbA1c level at 28 to 32 weeks of gestation were risk factors for FGR(all P<0.05).The rates of termination of pregnancy before 37 weeks,neonatal complications of polycythemia,asphyxia and very low birth weight infants in the observation group were significantly higher than those in the control group(all P<0.05).Conclusion:Early gestational age of GDM onset,unsatisfactory blood sugar control,concurrent gestational hypertension/preeclampsia,decreased amniotic fluid volume,repeated abnormal S/D value and elevated HbA1c levels at 28 to 30 weeks of pregnancy can increase the occurrence of FGR,GDM complicated with FGR will increase the risk of neonatal complications.

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备注/Memo

备注/Memo:
基金项目:西安市科技计划项目(2017117SF/YX011-1)
更新日期/Last Update: 2022-12-28