[强化产前护理和糖尿病护理对糖尿病母亲新生儿的影响——14年观察研究]

[Effect of intensive prenatal and diabetic care on newborn of diabetic mothers--14 years of observation].

作者信息

Mironiuk M, Kietlińska Z, Osuch B, Jezierska-Kasprzyk K, Kot A, Reinholz-Jaskólska M, Raźna I

机构信息

Katedry i Kliniki Połoznictwa i Ginekologii II wydz. Lek. A.M. w Warszawie.

出版信息

Ginekol Pol. 2001 Dec;72(12A):1260-6.

PMID:11883261

Abstract

UNLABELLED

Modern management of pregnancies complicated by maternal diabetes mellitus has in view delivery at term an healthy child with correct body mass and in good metabolic condition.

THE AIM

Of our work was estimation of influence of intensive prenatal and diabetical cares on frequency of occurrence of failures and complications at newborns of mothers with pregestational diabetes mellitus delivered in period from 1987 to 2000. Study include 228 of newborns of diabetic mothers of class B-RF according to White, born in our hospital between 25 and 40 weeks of pregnancy. In aim of estimation of percentage of perinatal mortality, congenital malformations, prematurity, hyper- and hypotrophy in examined population of new-born children of mothers with PGDM, material was subdivided into 3 groups in 4 and 5-years intervals: group I (n = 96) 1987-1990, group II (n = 72) 1991-1995, group III (n = 60) 1996-2000r.

RESULTS

Systematical decrease of percentage of perinatal mortality in examined groups from 7.3% to 5.0% was ascertained. There was a significant association between decreasing of number of congenital malformations in investigated new-born population from 12.5% to 5.0% and 2,5-times increasing of percentage of women with PGDM managed by combined team of diabetologist and obstetricians before conception. We observed an essential decreasing of percentage of prematurity in investigated material from 51.6% to 20.0%. Percentage of births of new-born children with macrosomy on space analysed of years was comparable. (13.7%, 14.1% and 15.0%) in spite of increasing of percentage of childbirths at term from to 80%. We did not ascertain increasing of percentage of incidents of IUGR. The percentage of IUGR in investigated groups carried out 5.3%, 5.6% and 5.0% in spite 2-times increasing of percentage of births of children of mothers with diabetes in class R and RF according to the White classification.

CONCLUSIONS

Well controlled diabetes, intensive management of diabetic women by combined team of diabetologists and obstetricians on space 14 of years of activity of our Department due to decreasing of percentage of: perinatal mortality from 7.3% to 5.0%, congenital malformations from 12.5% to 5.0% and premature deliveries from 51.6% to 20.0% in population of new-born children of mothers with PGDM.

摘要

未标注

妊娠合并糖尿病的现代管理目标是足月分娩出体重正常且代谢状况良好的健康婴儿。

目的

我们的研究旨在评估强化产前护理和糖尿病护理对1987年至2000年期间分娩的孕前糖尿病母亲所生新生儿出现不良情况和并发症频率的影响。研究纳入了228例根据怀特分类法为B-RF级糖尿病母亲所生的新生儿，这些新生儿在我院于妊娠25至40周出生。为了评估妊娠糖尿病母亲所生新生儿群体中围产期死亡率、先天性畸形、早产、巨大儿和低体重儿的百分比，将资料按4年和5年间隔分为3组：第一组（n = 96），1987 - 1990年；第二组（n = 72），1991 - 1995年；第三组（n = 60），1996 - 2000年。

结果

确定了被检查组围产期死亡率百分比从7.3%系统性下降至5.0%。在被调查的新生儿群体中，先天性畸形数量从12.5%降至5.0%，且孕前由糖尿病专家和产科医生联合团队管理的妊娠糖尿病女性百分比增加了2.5倍，二者之间存在显著关联。我们观察到被调查资料中早产百分比从51.6%大幅降至20.0%。在分析的年份区间内，巨大儿出生百分比具有可比性（分别为13.7%、14.1%和15.0%），尽管足月分娩百分比从[原文此处缺失数据]增至80%。我们未确定小于胎龄儿发生率百分比增加。尽管根据怀特分类法，R级和RF级糖尿病母亲所生孩子的出生百分比增加了2倍，但被调查组中小于胎龄儿的百分比分别为5.3%、5.6%和5.0%。