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目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)新诊断标准对改善母婴结局的意义。方法收集2010年9月至2014年8月在我院自愿建档、系统产检,并分娩的孕妇9 323例,采用不同诊断标准诊断分为研究组和对照组,统计GDM的发病率、胰岛素的使用率、GDM孕妇并发症及围生儿结局的差异,探讨不同诊断标准对妊娠及围生结局的影响。结果研究组较对照组GDM诊断率升高(14.7%vs.5.4%),剖宫产率下降(41.7%vs.47.7%)及产后出血率下降(12.4%vs.16.2%),巨大儿率下降(7.25%vs.13.29%),低出生体重儿率下降(0.42%vs.0.83%),差异均有统计学意义(P<0.05)。两组胰岛素使用率差异无统计学意义(4.5%vs.4.6%,P>0.05)。结论使用新诊断标准使GDM诊断率增加,未增加胰岛素的使用率及低出生体重儿的发生率,同时降低了剖宫产率、产后出血率及巨大儿发生率,改善了母婴的不良结局。
Objective To investigate the significance of new diagnostic criteria of gestational diabetes mellitus (GDM) in improving maternal and infant outcomes. Methods A total of 9 323 pregnant women who voluntarily archived, were systematically inspected and delivered in our hospital from September 2010 to August 2014 were divided into study group and control group according to different diagnostic criteria. The incidences of GDM, insulin Utilization rate, GDM complications of pregnant women and perinatal outcomes, to explore the impact of different diagnostic criteria on pregnancy and perinatal outcome. Results The diagnosis rate of GDM in study group was higher than that in control group (14.7% vs.5.4%), cesarean section rate (41.7% vs.47.7%) and postpartum hemorrhage rate (12.4% vs.16.2%), (7.25% vs.13.29%) and the rate of low birth weight (0.42% vs.0.83%), the differences were statistically significant (P <0.05). There was no significant difference in the rate of insulin use between the two groups (4.5% vs.4.6%, P> 0.05). Conclusions The diagnostic criteria of GDM increased with the use of new diagnostic criteria without increasing the rate of insulin use and the incidence of low birth weight infants, while reducing the incidence of cesarean section, postpartum hemorrhage and macrosomia, and improving maternal and infant adverse outcomes .