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印度北部一家三级医院中妊娠期糖尿病女性的妊娠结局

Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of north India.

作者信息

Saxena Pikee, Tyagi Swati, Prakash Anupam, Nigam Aruna, Trivedi Shubha Sagar

机构信息

Department of Obstetrics and Gynecology, Lady Hardinge Medical College and Shrimati Sucheta Kriplani Hospital, New Delhi, India.

出版信息

Indian J Community Med. 2011 Apr;36(2):120-3. doi: 10.4103/0970-0218.84130.

Abstract

BACKGROUND

Women with gestational diabetes mellitus (GDM) pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life.

OBJECTIVES

The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies.

MATERIALS AND METHODS

This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies.

RESULTS

Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all). Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001) among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05) in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero.

CONCLUSION

Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

摘要

背景

妊娠糖尿病(GDM)女性构成了一个重要的公共卫生问题,因为糖尿病不仅会影响母婴结局,而且这些女性及其胎儿日后患糖尿病及相关并发症的风险也会增加。

目的

本研究旨在确定50例糖尿病孕妇与50例血糖正常孕妇的母婴结局。

材料与方法

这是一项在三级医院进行的基于回顾性分析记录的研究。有关母亲、胎儿和分娩结局参数的详细信息记录在预先构建的表格中,并在血糖正常和糖尿病妊娠中进行比较。

结果

肥胖、家族糖尿病史、自然流产和既往妊娠有妊娠期糖尿病的患者,当前妊娠患GDM的发生率更高(所有P<0.05)。糖尿病妊娠中高血压、羊水过多、巨大儿、头盆不称和剖宫产更多见(P<0.001)。糖尿病母亲所生新生儿的先天性畸形、红细胞增多症、低钙血症和高胆红素血症也更多见(P<0.05),提示子宫内高血糖有不良影响。

结论

孕期糖尿病与更高的母婴发病率相关。因此,早期筛查、检测、密切监测和干预对于减少母婴短期和长期不良影响至关重要,尤其是在高危人群中。妊娠为临床医生提供了一个控制疾病进程并向这些患者灌输健康生活方式的机会。

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