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目的研究妊娠期糖尿病(gestationaldiabetesmellitus,GDM)合并子前期对新生儿出生体重及母儿并发症的影响。方法回顾分析中国医科大学附属盛京医院及解放军202医院2002-01-2004-12收治的GDM病例共127例,其中合并子前期者35例(Ⅱ组,余为Ⅰ组),以同期子前期35例(Ⅲ组)及正常妊娠35例(Ⅳ组)为对照,比较四组间新生儿出生体重之间的差异,以及Ⅰ、Ⅱ组母儿并发症。结果(1)GDM孕妇子前期的发生率(27.6%,35/127)明显高于同期子前期的发生率(6.97%,353/5066),差异有统计学意义(P<0.01)。(2)Ⅰ组与Ⅱ组新生儿出生体重差异无统计学意义(P>0.05),Ⅱ组明显高于Ⅲ组及Ⅳ组(P均<0.01)。(3)所有GDM病例中小于胎龄儿2例,均合并重度子前期。(4)Ⅰ组与Ⅱ组孕妇羊水过多、酮症酸中毒等的发生率及新生儿红细胞增多症等的发生率差异无统计学意义(P均>0.05);Ⅱ组孕妇手术产的发生率高于Ⅰ组(P<0.05),新生儿窒息及转科的发生率也明显高于Ⅰ组(P<0.05)。结论GDM易合并子前期,且GDM合并子前期者中,孕妇早产、胎膜早破等围生期并发症增多,新生儿大于胎龄儿及低血糖等并发症亦增多。
Objective To study the effect of gestational diabetes mellitus (GDM) combined with preeclampsia on newborn birth weight and maternal complications. Methods A total of 127 GDM cases admitted to Shengjing Hospital affiliated to China Medical University and 202 Hospital of People’s Liberation Army from January 2002 to December 2002 were retrospectively analyzed. Among them, 35 cases had premalodulatory conjunctival lymph nodes (group Ⅱ and group I) 35 cases of preeclampsia (group Ⅲ) and 35 cases of normal pregnancy (group Ⅳ) as control, the difference of newborn’s birth weight between the four groups and the complication of maternal and females in group Ⅰ and Ⅱ were compared. Results (1) The incidence of preeclampsia in pregnant women with GDM was significantly higher than that in presymptomatic women (27.6%, 35/127) (6.97%, 353/5066). The difference was statistically significant (P <0.01). (2) There was no significant difference in birth weight between newborns in group Ⅰ and group Ⅱ (P> 0.05), while those in group Ⅱ were significantly higher than those in group Ⅲ and Ⅳ (all P <0.01). (3) All GDM cases were less than 2 gestational age children, were combined with severe preeclampsia. (4) There was no significant difference in the incidence of polyhydramnios, ketoacidosis and neonatal polycythemia among group Ⅰ and group Ⅱ (all P> 0.05). The incidence of operation in group Ⅱ The incidence of neonatal asphyxia and pediatric transfusion was also significantly higher than that of group Ⅰ (P <0.05). Conclusions The premenstrual complications such as premature labor and premature rupture of membranes in GDM patients complicated with preeclampsia and GDM combined with preeclampsia are increased. The complications such as neonates with more than gestational age and hypoglycemia also increase.