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目的观察孕前糖尿病和妊娠期糖尿病患者的母婴结局。方法选取2013年1月-2015年5月在该院营养门诊就诊并住院分娩的妊娠合并糖尿病患者879例进行回顾性分析,分为孕前糖尿病(PGDM,68例)和妊娠期糖尿病(GDM,811例)两组,对比分析母婴结局情况。结果本研究中妊娠期高血压疾病的总发病率为5.2%,PGDM患者妊娠期高血压疾病的发病率(16.2%)显著高于GDM患者(4.3%)(P<0.05)。通过营养治疗,妊娠合并糖尿病巨大儿的发病率为6.5%,新生儿黄疸的发病率为5.0%。巨大儿的发病率、新生儿黄疸的发病率PGDM患者与GDM患者比较差异无统计学意义(P>0.05)。PGDM患者新生儿低血糖发病率略高于GDM患者,但差异无统计学意义(P>0.05)。PGDM患者新生儿肺炎和早产儿的发病率(19.1%、16.2%)显著高于GDM患者(9.5%、4.8%)(P<0.05)。结论 PGDM患者的母婴并发症比GDM严重,应在孕期指导糖尿病患者饮食和运动相结合,并配合使用胰岛素,保持血糖平稳,降低母婴并发症的发病率。
Objective To observe the maternal and infant outcomes of pre-pregnancy diabetes mellitus and gestational diabetes mellitus. Methods A retrospective analysis was conducted on 879 pregnant women with gestational diabetes mellitus who were treated at outpatient nutrition clinics and hospitalized for delivery from January 2013 to May 2015. The patients were divided into pre-pregnancy diabetes (PGDM, 68 cases) and gestational diabetes mellitus (GDM, 811 Cases) two groups, comparative analysis of maternal and child outcomes. Results The overall incidence of gestational hypertension was 5.2% in this study. The incidence of gestational hypertension in PGDM patients (16.2%) was significantly higher than that in GDM patients (4.3%) (P <0.05). Through nutritional therapy, the incidence of macrosomia in pregnancy with diabetes is 6.5% and the incidence of neonatal jaundice is 5.0%. The incidence of huge children, neonatal jaundice incidence of PGDM patients and GDM patients was no significant difference (P> 0.05). The incidence of neonatal hypoglycemia in PGDM patients was slightly higher than that in GDM patients, but the difference was not statistically significant (P> 0.05). The incidence of neonatal pneumonia and preterm birth in PGDM patients (19.1%, 16.2%) was significantly higher than that in GDM patients (9.5%, 4.8%) (P <0.05). Conclusion The maternal and neonatal complications of PGDM patients are more serious than that of GDM. They should guide the diet and exercise of diabetic patients during pregnancy and use insulin in combination to maintain stable blood sugar and reduce the incidence of maternal and infant complications.