妊娠期糖尿病的复发率、复发的危险因素及复发性妊娠期糖尿病母婴预后的分析

摘要

[目的]研究妊娠期糖尿病(GDM)的复发率、复发的危险因素及复发性GDM的母婴预后.[方法]选取2016年1～12月在本院产科门诊进行产检的既往曾发生过1次GDM的孕妇142例进行追踪,至糖尿量试验(OGTT)时自动分为两组,76例复发GDM患者进入观察组,66例未发作糖尿病孕妇进入阴性对照组,同时随机选取初发GDM患者80例为阳性对照组;三组患者根据临床随访表追踪至产后半年,观察并统计母婴预后,筛选复发GDM的危险因素.[结果]GDM复发率为54.2％,观察组与阴性对照组相比,上次妊娠时空腹血糖(FPG)、餐后2小时血糖(2hPG)、本次孕前体质量指数(BMI)、本次妊娠孕妇孕时及产时并发症、新生儿并发症均有显著性差异.观察组与阳性对照组相比,产次,部分孕妇孕时、产时并发症,部分新生儿并发症之间有差异,产后OG-TT结果的差异有显著性.疾病复发的危险因素包括本次妊娠前BMI,上次妊娠FPG、2hPG.[结论]上次妊娠FPG及2hPG越高,本次孕前体质量越重,则GDM越可能复发.复发GDM患者与初发GDM患者相比,新生儿更易发生低血糖症及卵圆孔未闭,产后长期遗留糖尿病风险增高.%[Objective]To study the recurrence rate,risk factors of recurrence of gestational diabetes mellitus(GDM)and the prognosis of mother and infant in recurrent GDM.[Methods]A total of 142 pregnant women who had ever had GDM from January to December 2016,who had been examined in our hospital＇s obstetrical clinic were followed up.At the time of OGTT,76 patients with recurrent GDM entered the observation group and 66 preg-nant women without diabetes mellitus entered the negative control group.At the same time,80 patients with pri-mary GDM were randomly selected as the positive control group.The three groups were followed up to 6 months postpartum according to the clinical follow-up table to observe and calculate the prognosis of mother and infant and to screen the risk factors for recurrence of GDM.[Results]The recurrence rate of GDM was 54.2％.Compared the observation group with the negative control group,there were significant differences between the two groups in fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPG),the pre-pregnancy body mass index(BMI),the complications during pregnancy and delivery and neonatal complications.Compared with the positive control group,there were differences between the observation group and the positive control group in the number of births,the complications of some pregnant and delivery women,the complications of some newborns ;the differences in the results of postpartum OGTT were significant.Risk factors for relapse included BMI before this pregnancy,the FGP and 2 hPG at last pregnancy.[Conclusion]The higher the FPG and 2hPG in the last pregnan-cy,the heavier the weight of the pregnancy,the more likely the GDM will recur.The higher the FPG and 2hPG in the last pregnancy,the heavier the weight of the pregnancy,the more likely the GDM will recur.Infants of pa-tients with recurrent GDM are more likely to develop hypoglycemia and unobturated foramen ovale than those with primary GDM,and the risk of long term postpartum diabetes is increased.