妊娠期糖尿病对婴儿出生后并发症及智能行为发育的影响

摘要

目的 探讨妊娠期糖尿病(GDM)对婴儿出生后并发症及智能行为发育的影响.方法 收集108例妊娠期糖尿病母亲婴儿(GDM组)及120例健康母亲婴儿(对照组)的临床资料,按母亲糖代谢控制程度将GDM组分为血糖控制正常组87例(GDM1组)及血糖控制不良组21例(GDM2组).比较GDM组与对照组、GDM1组与GDM2组出生后的并发症发生情况.对所有婴儿进行随访,比较对照组、GDM1组与GDM2组出生42 d、3月龄和6月龄的盖泽尔智能评分.结果 GDM组的低血糖、高胆红素血症、早产、窒息、大于胎龄儿(LGA)、小于胎龄儿(SGA)、红细胞增多症、先天畸形、肺炎的发生率均高于对照组(P＜0.05).GDM2组的低血糖、早产儿、LGA、SGA、高胆红素血症、肺炎的发生率均高于GDM1组(P＜0.05).3组的盖泽尔智能评分均随时间的延长而增高(P＜0.05),而各时间点对照组的评分高于其他两组(P＜0.05),但GDM1组与GDM2组间比较,差异无统计学意义(P＞0.05).结论 GDM对子代各种病理并发症的发生和早期智能行为发育均可能有影响.%Objective To explore the influence of gestational diabetes mellitus(GDM) on postnatal complications and neurobehavioral development of infants.Methods The clinical data of 108 infants whose mothers suffering GDM(GDM group)and 110 infants of healthy mothers (control group) were collected.The GDM group was divided into well-controlled blood glucose group(GDM1 group,n=87)and poorly-controlled blood glucose group(GDM2 group,n=21) according to the results of blood glucose control of the mothers.The incidence of complications after birth was compared between the GDM group and the control group,also between the GDM1 group and the GDM2 group.A follow-up was performed in all infants,and the scores of Gesell Development Scale were compared among the control group,the GDM1 group and the GDM2 group at 42 days,three months and six months after birth.Results The incidence rates of hypoglycemia,hyperbilirubinemia,premature delivery,asphyxia,large-for-gestational-age(LGA) infant,small-for-gestational-age(SGA) infant,polycythemia,congenital malformation and pneumonia were higher in the GDM group compared to the control group(P＜0.05).The incidence rates of hypoglycemia,premature delivery,LGA infant,SGA infant,hyperbilirubinemia and pneumonia were higher in the GDM2 group compared to the GDM1 group(P＜0.05). The scores of Gesell development scale increased over time in the three groups(P＜0.05).At each time point,the scores of the control group were higher than those of other two groups(P＜0.05),but there was no significant difference between the GDM1 group and the GDM2 group(P＞0.05).Conclusion GDM might affect the incidence of pathological complications and early neurobehavioral development of offspring.