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目的探讨妊娠期糖尿病不同诊断标准对于妊娠结局的影响。方法对8046例孕妇进行葡萄糖耐量试验(OGTT)。按照第7版《妇产科学》标准和IADPSG两种标准对孕妇进行妊娠期糖尿病诊断,将采用IADPSG标准诊断为GDM而采用第7版《妇产科学》标准并未诊断为GDM及GIGT的孕妇随机为干预组(A组)和非干预组(B组),对A组按GDM进行干预与管理,另选180例正常孕妇为对照组(C组),对三组的母儿妊娠结局进行比较。结果①8046例孕妇根据第7版《妇产科学》标准诊断GDM及GIGT患者共368例,检出率为4.57%,根据IADPSG标准诊断GDM患者共655例,检出率为8.14%。②A组、C组的肩难产、剖宫产发生率低于B组,组间差异有统计学意义(P<0.05),A组、B组、C组的妊娠期高血压疾病、羊水过多、胎膜早破、产后出血的发生率比较,差异无统计学意义(P>0.05)。A组、C组的新生儿平均出生体重儿、低血糖发生率明显低于B组(P<0.05),A组、B组、C组的胎儿窘迫、高胆红素血症、早产儿发生率、低出生体重儿、围产儿死亡的发生率比较,差异无统计学意义(P>0.05)。结论按2010年IADPSG诊断标准,可增加3.57%的孕妇确诊为妊娠期糖尿病,通过管理,可以降低新生儿出生低体重、肩难产、新生儿低血糖的发生率及剖宫产率。
Objective To investigate the effect of different diagnostic criteria of gestational diabetes on pregnancy outcome. Methods 8046 pregnant women were subjected to glucose tolerance test (OGTT). According to the 7th edition of Obstetrics and Gynecology standards and IADPSG two criteria for pregnant women with gestational diabetes diagnosis will be used IADPSG standard diagnostic for GDM and the seventh edition of Obstetrics and Gynecology standards have not been diagnosed as GDM and GIGT pregnant women Randomly intervention group (group A) and non-intervention group (group B), according to GDM intervention and management in group A, another 180 normal pregnant women as control group (group C), the three groups of maternal and child pregnancy outcomes Compare Results ①8046 pregnant women diagnosed 368 cases of GDM and GIGT according to the 7th edition of Obstetrics and Gynecology, with a detection rate of 4.57%. A total of 655 GDM patients were diagnosed according to the IADPSG standard, with a detection rate of 8.14%. (2) The incidence of shoulder dystocia and cesarean section in group A and group C was lower than that in group B (P <0.05). The incidences of gestational hypertension, polyhydramnios in group A, group B and group C were significantly higher , Premature rupture of membranes, the incidence of postpartum hemorrhage, the difference was not statistically significant (P> 0.05). The average neonatal birth weight and the incidence of hypoglycemia in group A and group C were significantly lower than those in group B (P <0.05). Fetal distress, hyperbilirubinemia and premature infants in groups A, B and C Rates, low birth weight children, perinatal mortality rates, the difference was not statistically significant (P> 0.05). Conclusions According to the diagnostic criteria of IADPSG in 2010, 3.57% pregnant women can be diagnosed as gestational diabetes mellitus. Management can reduce the incidence of low birth weight, shoulder dystocia, neonatal hypoglycemia and cesarean section rate.