德里一家三级护理医院中妊娠期糖尿病的母婴及围产期结局
Maternal and Perinatal Outcome in Gestational Diabetes Mellitus in a Tertiary Care Hospital in Delhi.
作者信息
Kumari Rajesh, Dalal Venus, Kachhawa Garima, Sahoo Ipshita, Khadgawat Rajesh, Mahey Reeta, Kulshrestha Vidushi, Vanamail Perumal, Sharma J B, Bhatla Neerja, Kriplani Alka
机构信息
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):116-120. doi: 10.4103/ijem.IJEM_582_17.
BACKGROUND
Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome.
AIM
The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy.
MATERIALS AND METHODS
It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years. Another 191 women with normal pregnancy without GDM and other medical conditions were taken as control. The baseline characteristics (age, body mass index, religion, and socioeconomic status) were noted in all cases. Diagnosis of GDM was made using oral glucose tolerance test with 75 g glucose. GDM patients were started on diet following which insulin or oral hypoglycemic agents were given if required. Maternal and perinatal outcome was noted in all women.
RESULTS
The prevalence of GDM was 5.72% (170/2970). Most patients (79.41%) could be controlled on diet alone. However, 21 (12.35%) needed insulin and 14 (8.23%) needed oral hypoglycemic agents. Middle socioeconomic status was more common in GDM than control and pregnancy-induced hypertension was more common in GDM (13.5%) than in control (6.3%) ( = 0.019). Mode of delivery was not different in two groups. Instrumental deliveries and postpartum hemorrhage were also similar. However, mean birth weight was significantly higher in GDM (2848 ± 539 g) than in control (2707 ± 641 g) ( = 0.004). Incidence of large-for-date babies was also higher (28.2%) in GDM than control (19.4%) ( = 0.005). In neonatal complication, hypoglycemia was significantly higher in GDM (20.6%) than in control (5.2%) ( = 0.001). However, the incidence of hyperbilirubinemia and congenital malformations was not significantly different in two groups.
CONCLUSION
The prevalence of GDM was 5.72% in this study. Adequate treatment of GDM on diet, oral hypoglycemic agents, or insulin to achieve euglycemia can achieve near-normal maternal and neonatal outcome.
背景
妊娠期糖尿病（GDM）被定义为首次在孕期诊断出的碳水化合物不耐受，可能与不良的母婴和围产期结局相关。
目的
本研究的目的是确定孕期GDM患者的母婴和围产期结局。
材料与方法
这是一项对过去5年内在我院接受产前检查并分娩的GDM女性患者的回顾性分析。另外选取191例无GDM及其他疾病的正常妊娠女性作为对照。记录所有病例的基线特征（年龄、体重指数、宗教信仰和社会经济地位）。采用75g葡萄糖口服葡萄糖耐量试验诊断GDM。GDM患者先进行饮食控制，必要时给予胰岛素或口服降糖药。记录所有女性的母婴和围产期结局。
结果
GDM的患病率为5.72%（170/2970）。大多数患者（79.41%）仅通过饮食就能控制病情。然而，21例（12.35%）需要胰岛素治疗，14例（8.23%）需要口服降糖药。GDM患者中社会经济地位中等的情况比对照组更常见，妊娠期高血压在GDM患者中（13.5%）比对照组（6.3%）更常见（P = 0.019）。两组的分娩方式无差异。器械助产和产后出血情况也相似。然而，GDM患者的平均出生体重（2848±539g）显著高于对照组（2707±641g）（P = 0.004）。GDM患者中巨大儿的发生率（28.2%）也高于对照组（19.4%）（P = 0.005）。在新生儿并发症方面，GDM患者中低血糖的发生率（20.6%）显著高于对照组（5.
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