Objective To explore the adverse pregnancy outcomes of gestational diabetes mellitus (GDM ) in two hospitals in Shenzhen and to evaluate the effects of GDM joint clinic in GDM patients .Methods We retrospectively analyzed the clinical features of 376 GDM and 400 pregnant women with normal glucose tolerance (GNGT) who delivered in Shenzhen Hospital of the University of HongKong or Longgang District Central Hospital of Shenzhen between Aug .2013 and Jul .2015.The pregnancy outcomes among GDM patients accepted joint clinic management (joint group,n=316),GDM with routine care (Con group,n=60) and the GNGT group were compared and analyzed .Results (1) Compared with Con group,the changes of body weight [(12.94 ± 4.64) vs (14.87 ± 5.45) kg,P＜0.05] and BMI [(5.01 ± 1.79) vs (5.74 ± 2.12) kg/m2,P＜ 0.05]during pregnancy was less in joint group .The incidence of premature infants were less in study group [3.48%(11/316) vs 10.00%(6/60),P＜0.05] .The rate of insulin use was higher in joint clinic group (17.09%) than in Con group (1.67%) ( P ＜ 0.05 ) .(2) Compared with GNGT group,the age [(31.88 ± 4.07) vs (30.39 ± 4.22)y,P＜0.05] pre-pregnant body weight [(55.04 ± 7.81) vs (52.55 ± 6.71)kg,P＜0.05] and BMI [(21.24 ± 2.66) vs (20.35 ± 2.34)kg/m2,P＜0.05] were higher in joint clinic group;while the body weight change [(12.94 ± 4.64 ) vs (15.20 ± 4.10) kg,P＜0.05] and BMI change [(5.01 ± 1.79) vs (5.89 ± 1.59) kg/m2,P＜0.01]during pregnancy was less .The gestational weeks of GDM patients in joint clinic group were lower than that in GNGT group [(38.78 ± 1.12) vs (39.05 ± 1.28)week,P＜ 0.01] .There were no difference in the adverse outcomes between joint group and GNGT group .(3) Compared with GNGT group,the pre-pregnant BMI was higher in Con group [(21.03 ± 2.67) vs (20.35 ± 2.34) kg/m2,P＜0.05],while the gestational week was lower [(38.50 ± 1.99) vs (39.05 ± 1.28) week,P＜0.05] .The newborn premature rate was higher in Con group than that in GNGT group [10.00%(6/60) vs 2.75%(11/400),P＜0.05] .Conclusion GDM joint clinic can help decrease the premature rates in these patients with GDM .%目的 分析深圳地区GDM患者的妊娠不良结局,评价GDM 联合门诊的效果.方法回顾性分析2013年8月至2015年7月于香港大学深圳医院及深圳龙岗中心医院分娩的GDM 患者376例和糖耐量正常孕妇(GNGT组) 400名的临床资料,探讨参加GDM联合门诊组(联合监管组,n=316) 、未参加GDM联合门诊组即对照(Con,n=60)组与GNGT 组母婴结局差异.结果 (1)联合监管组孕期体重和BMI增加均低于Con组[(12.94 ± 4.64) vs (14.87 ± 5.45) kg,P＜ 0.05],[(5.01 ± 1.79) vs (5.74 ± 2.12) kg/m2,P＜0.05].联合监管组早产儿发生率低于Con组[3.48%(11/316) vs 10.00%(6/60),P＜0.05],胰岛素使用率高于Con组[17.09%(54/316) vs 1.67%(1/60),P＜0.05];(2)联合监管组年龄、孕前体重和BMI均高于GNGT组[(31.88 ± 4.07) vs (30.39 ± 4.22)岁,(55.04 ± 7.81) vs (52.55 ± 6.71)kg,(21.24 ± 2.66) vs (20.35 ± 2.34)kg/m2,P＜0.05],孕期体重增加、BMI增加低于GNGT 组[(12.94 ± 4.64) vs (15.20 ± 4.10) kg,(5.01 ± 1.79) vs (5.89 ± 1.59) kg/m2,P＜0.05],联合监管组的分娩孕周低于GNGT组[(38.78 ± 1.12) vs (39.05 ± 1.28)周,P＜0.05],两组母婴不良结局比较,差异无统计学意义;(3)Con组孕前BMI高于GNGT组[(21.03 ± 2.67) vs (20.35 ± 2.34) kg/m2,P＜0.05],分娩孕周低于GNGT组[(38.50 ± 1.99) vs (39.05 ± 1.28)周,P＜0.05],早产儿发生率高于GNGT组[10.00%(6/60) vs 2.75%(11/400),P＜0.05].结论 GDM 联合门诊可降低GDM 的早产率.
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