目的 探讨妊娠期糖尿病应用国际糖尿病与妊娠研究组(IADPSG)诊断标准的合理性.方法 对50g糖筛查阳性孕妇进行葡萄糖耐量实验,分别根据第7版妇产科教科书及IADPSG诊断标准诊断妊娠期糖尿病并分组,取同期非妊娠期糖尿病孕妇作为对照组,比较各组间妊娠结局.结果 教科书诊断标准诊断阳性率9.7%,IADPSG诊断标准诊断阳性率12.3%.,按 IADPSG诊断标准属于漏诊组的剖宫产率、子痫前期、羊水过多发生率均高于对照组,新生儿窒息、新生儿低血糖、巨大儿、大于胎龄儿发生率均高于对照组,按 IADPSG诊断标准属于过度诊断组,剖宫产率、子痫前期、羊水过多、胎膜早破、早产发生率与对照组比较均无明显差异,巨大儿、大于胎龄儿发生率、新生儿高胆红素血症、新生儿转儿科率与对照组比较亦无明显差异.结论 与教科书诊断标准相比,IADPSG诊断标准意味着孕期需要干预的妊娠期糖尿病孕妇增加,其围产期并发症明显增加,在我国采用IADPSG诊断标准是合理的.%Objective To study the diagnostic criteria for gestational diabetes mellitus. Methods Pregnant women received 50 g glucose screen test(GST) between 24 to 28 gestational weeks. Positive subjects received a 78 g oral glu cose tolerance test(OGTT). The diagnosis of GDM were according to two diagnostic criteria: Yue Jie and IADPSG (The International Association of Diabetes and Pregnancy Study Groups). Negative screeners were selected as control group. The outcomes of the mother and the neonate of these groups were compared. Results The incidence of GDM was 9. 7% and 12. 3% by these two diagnostic criteria. In groups diagnosed by IADPSG criteria but not diagnosed by the other one,the maternal complications including cesarean section, preeclampsia,polyhydramnios and neonatal complipared with control group. And in groups not diagnosed by IADPSG criteria but diagnosed by the other one,the maternal complications including cesarean section, preeclampsia, polyhydramnios, preterm ruptured of membrane, preterm birth and neonatal complications including macrosomia , larger for gestational age, hyperbilirubinemia, ICU nursing were no significant differences compared with control group. Conclusion IADPSG criteria which means more perinatal compli cations could increase the management of GDM. IADPSG criteria is more reasonable in our country.
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