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妊娠期异常葡萄糖耐量与母婴结局的关系。

Association between gestational abnormal glucose tolerance and maternal-fetal outcomes.

机构信息

Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan.

Department of Midwifery and Maternal-Infant Health Care, Fooyin University, Kaohsiung, Taiwan.

出版信息

J Obstet Gynaecol Res. 2022 Oct;48(10):2505-2513. doi: 10.1111/jog.15350. Epub 2022 Jul 5.

DOI:10.1111/jog.15350
PMID:35790472
Abstract

AIM

To investigate the relationship between abnormal glucose tolerance during pregnancy and maternal-fetal outcomes, after categorizing women into groups with different levels of gestational abnormal glucose tolerance.

METHODS

A total of 1858 pregnant women who received two-step screening for gestational diabetes mellitus (GDM) at Fooyin University Hospital were categorized into four groups, according to their glucose abnormalities, and their maternal-fetal outcomes were investigated from October 2015 to June 2020.

RESULTS

Among the groups having different levels of abnormal glucose tolerance, there were significant differences and trends in mother's age, currently married status, and prepregnancy overweight or obesity, incidences of cesarean section, preterm, and gestational hypertension or preeclampsia; and with respect to neonatal incidence of large for gestational age (LGA), average weight, and average height (p < 0.05). After adjusting for potential factors, there were higher incidences of cesarean section (AOR = 1.71; 95% confidence interval [CI]: 1.12-2.61), preterm (AOR = 2.20; 95% CI: 1.23-3.91), neonatal LGA (AOR = 4.94; 95% CI: 2.87-8.51), and neonatal intensive care unit (NICU) admission (AOR = 2.66; 95% CI: 1.14-6.24) in the GDM group, relative to the control group. Furthermore, the women in the oral glucose tolerance test (OGTT)-1 group had a higher incidence of neonatal LGA when compared with the women in the normal group (AOR = 2.31; 95% CI: 1.02-5.33).

CONCLUSIONS

We found higher incidences of cesarean section, preterm, and neonatal LGA and NICU admission in the GDM women, and a higher incidence of neonatal LGA in the OGTT-1 group, relative to control group.

摘要

目的

通过对不同程度妊娠期异常葡萄糖耐量的孕妇进行分组,探讨妊娠期异常葡萄糖耐量与母婴结局的关系。

方法

选取 2015 年 10 月至 2020 年 6 月在辅英科技大学医院行两步法筛查妊娠期糖尿病(GDM)的 1858 例孕妇,根据其血糖异常情况分为 4 组,调查其母婴结局。

结果

不同程度异常葡萄糖耐量组间,母亲年龄、目前已婚状态、孕前超重或肥胖、剖宫产、早产、妊娠期高血压或子痫前期发生率以及新生儿巨大儿(LGA)、平均体重、平均身高发生率存在差异且呈趋势(p<0.05)。调整潜在因素后,GDM 组剖宫产(AOR=1.71,95%CI:1.122.61)、早产(AOR=2.20,95%CI:1.233.91)、新生儿 LGA(AOR=4.94,95%CI:2.878.51)及新生儿重症监护病房(NICU)入住(AOR=2.66,95%CI:1.146.24)的发生率均高于对照组。进一步分析发现,与正常组相比,OGTT-1 组新生儿 LGA 的发生率更高(AOR=2.31,95%CI:1.02~5.33)。

结论

与对照组相比,GDM 孕妇剖宫产、早产及新生儿 LGA 和 NICU 入住的发生率更高,OGTT-1 组新生儿 LGA 的发生率更高。

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