早期随机毛细血管血糖水平筛查及多学科产前团队合作以改善妊娠期糖尿病的结局

Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus.

作者信息

Berg Marie, Adlerberth Annika, Sultan Bo, Wennergren Margareta, Wallin Gunnar

机构信息

The Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, and Department of Obstetrics and Gynaecology, The Institute of Clinical Sciences, Sahlgrenska University Hospital, Sweden.

出版信息

Acta Obstet Gynecol Scand. 2007;86(3):283-90. doi: 10.1080/00016340601110747.

DOI:10.1080/00016340601110747

PMID:17364301

Abstract

BACKGROUND

This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group.

METHODS

A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM.

RESULTS

GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively.

CONCLUSION

Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.

摘要

背景

本研究描述了妊娠糖尿病（GDM）女性的母婴特征及分娩结局，并与对照组进行比较。

方法

在瑞典一个市区对719例GDM女性进行了一项回顾性观察研究。同一医院的所有其他产妇作为对照组。从妊娠早期开始，定期使用随机毛细血管血糖水平诊断GDM。血糖水平≥7.0 mmol/l（127.8 mg/dl）时进行口服葡萄糖耐量试验。根据诊断时的血糖水平，即轻度或重度GDM对数据进行分析。

结果

2.28%年龄较大且体重指数（BMI）较高的女性被诊断为GDM。很大一部分是非北欧裔（44.5%）；她们患重度GDM的比例（49.1%）高于北欧组（33.1%）。与重度GDM组相比，轻度GDM组的并发症和异常情况较少，不过两组在这方面均与对照组不同。轻度GDM组、重度GDM组和对照组的自然分娩率分别为70.2%、65.7%和81.0%。分别有4.8%、10.5%和3.2%的胎儿为大于胎龄儿（+2标准差）。