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目的:通过苏州地区妊娠期糖尿病(GDM)的筛查,了解妊娠期糖代谢异常的发病率及对妊娠的不良影响。方法:采用前瞻性的研究方法,2004年8月～2006年12月对苏州市各大医院及太仓市建卡的大部分孕妇采用50g葡萄糖负荷试验,共筛查孕妇4166例,阳性者再做75g葡萄糖耐量试验(OGTT)。设糖尿病组(GDM)及糖耐量异常组(IGT),以糖筛查正常的孕妇作对照组,对临床资料进行分析。结果:筛查4166例孕妇中GCT阳性者1394例(33.46%),总糖代谢异常率为6.29%,其中GDM150例(3.60%)、糖耐量异常(IGT)者为112例(2.69%)。GDM及IGT的发生率随孕妇年龄增大而显著升高(P<0.01)。新生儿出生体重GDM组和IGT组与对照组相比,有显著性差异(P<0.05),GDM孕妇巨大儿占19.33%。GDM孕妇中剖宫产76.67%,子痫前期9.33%、羊水过多7.33%,均明显高于对照组,早产4例,1例新生儿死亡。结论:妊娠期糖筛查有利于早期检出妊娠期糖代谢异常的孕妇,以便加强管理,减少对母儿的不良影响。
Objective: To investigate the incidence of gestational diabetes mellitus (GDM) in Suzhou and to understand the incidence of abnormal glucose metabolism in pregnancy and adverse effects on pregnancy. Methods: A prospective study was conducted. From August 2004 to December 2006, 506g glucose load test was performed on most of the pregnant women who built the cards in Suzhou City and Taicang City. A total of 4,166 pregnant women were screened, and the positives were re-done 75g glucose tolerance test (OGTT). The patients with diabetes mellitus (GDM) and impaired glucose tolerance group (IGT) were enrolled. The pregnant women with normal glucose screening were used as the control group. The clinical data were analyzed. Results: 1394 (33.46%) GCT positive cases were detected in 4166 pregnant women. The total abnormal glucose metabolism rate was 6.29%. There were 112 cases (2.69%) with GDM in 150 cases (3.60%) and impaired glucose tolerance (IGT). The incidence of GDM and IGT increased significantly with the age of pregnant women (P <0.01). Neonatal birth weight GDM group and IGT group compared with the control group, there was a significant difference (P <0.05), GDM pregnant women accounted for 19.33% of the huge children. GDM pregnant women in cesarean section 76.67%, 9.33% preeclampsia, polyhydramnios 7.33%, were significantly higher than the control group, 4 cases of premature birth, 1 case of neonatal death. Conclusion: Gestational screening of glucose is beneficial to the early detection of pregnant women with abnormal glucose metabolism during pregnancy in order to strengthen management and reduce the adverse effects on maternal and child.