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围产结局及相关危险因素分析:单胎妊娠与双胎妊娠并发妊娠期糖尿病的比较:荟萃分析。

Perinatal Outcomes and Related Risk Factors of Single vs Twin Pregnancy Complicated by Gestational Diabetes Mellitus: Meta-Analysis.

机构信息

Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China.

出版信息

Comput Math Methods Med. 2022 Jul 4;2022:3557890. doi: 10.1155/2022/3557890. eCollection 2022.

Abstract

OBJECTIVE

Perinatal outcomes and related risk factors of single vs twin pregnancy complicated with gestational diabetes mellitus (GDM) were clarified, providing evidence for developing preventive measures.

METHODS

The Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), CQVIP, Wanfang, and PubMed databases were searched for published research on the perinatal outcomes and risk factors of single and twin pregnancy complicated by GDM from 2000 to 2021. The quality of the included literature was evaluated according to the Newcastle-Ottawa Scale (NOS). Meta-analysis of the included literature was conducted using RevMan5.3 software.

RESULTS

Relative to a single pregnancy group, infertility, gestational weight gain, and family history of diabetes presented statistical significance in the twin pregnancy group ( < 0.05); gestational age at delivery, cesarean section, preterm birth < 37 weeks, and preeclampsia presented statistical significance in the twin pregnancy group ( < 0.05); and neonatal birth weight, small for gestational age (SGA), neonatal asphyxia, neonatal hypoglycemia, neonatal respiratory distress syndrome (NRDS), neonatal hyperbilirubinemia, and neonatal death presented statistical significance in the twin pregnancy group ( < 0.05).

CONCLUSION

Infertility, prenatal weight gain, and diabetes in the family are all risk factors for postpartum impaired glucose metabolism in pregnant women with GDM who are carrying twins. The gestational age at delivery, cesarean section, preterm birth < 37 weeks, and preeclampsia of twin pregnant women with diabetes will affect the perinatal status of twin pregnant women. Neonatal birth weight, SGA, neonatal asphyxia, neonatal hypoglycemia, NRDS, neonatal hyperbilirubinemia, neonatal death, etc. should be paid special attention in the perinatal process.

摘要

目的

明确单胎妊娠与双胎妊娠并发妊娠期糖尿病(GDM)的围产结局及其相关危险因素,为制定预防措施提供依据。

方法

计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库和 PubMed 数据库,收集 2000 年至 2021 年发表的关于单胎与双胎妊娠并发 GDM 的围产结局及其危险因素的研究,根据纽卡斯尔-渥太华量表(NOS)评价纳入文献的质量,采用 RevMan5.3 软件进行 Meta 分析。

结果

与单胎妊娠组比较,双胎妊娠组不孕、孕期体重增加、糖尿病家族史差异有统计学意义( < 0.05);双胎妊娠组的分娩孕周、剖宫产、早产<37 周及早产、子痫前期差异有统计学意义( < 0.05);双胎妊娠组新生儿出生体质量、小于胎龄儿(SGA)、新生儿窒息、新生儿低血糖、新生儿呼吸窘迫综合征(NRDS)、新生儿高胆红素血症、新生儿死亡差异有统计学意义( < 0.05)。

结论

不孕、孕期体重增加、糖尿病家族史均为 GDM 双胎妊娠产妇产后糖代谢异常的危险因素。GDM 双胎妊娠孕妇的分娩孕周、剖宫产、早产<37 周及早产、子痫前期等均会影响双胎妊娠的围产结局,应在围产过程中特别关注新生儿出生体质量、SGA、新生儿窒息、新生儿低血糖、NRDS、新生儿高胆红素血症、新生儿死亡等情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f992/9273416/db9d0a574c0a/CMMM2022-3557890.001.jpg

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