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目的分析妊娠期糖尿病(gestationaldiabetesmellitus,GDM)不同诊断标准在孕产妇中的应用情况,探讨更适合本地区GDM的诊断标准。方法选择河南省省直第一医院围产保健门诊孕妇651例为研究对象,其中301例为观察组,采用国际妊娠与糖尿病研究组织(IADPSG)的标准诊断GDM;350例为对照组,采用两步法GDM标准诊断GDM,比较两组孕妇GDM发生率及妊娠结局。结果观察组GDM检出率为13.20%,对照组GDM检出率为5.14%,差异有统计学意义(P<0.05);在围产儿结局方面,对照组巨大儿、新生儿呼吸窘迫综合征、早产、胎儿生长受限的发生率均>观察组,差异均有统计学意义(P<0.05);两组胎儿畸形发生率差别不大,差异无统计学意义(P>0.05)。两组孕妇在妊娠高血压疾病、羊水过多、剖宫产率、产褥感染、产后出血方面,对照组发生率均高于观察组,差异均有统计学意义(P<0.05)。结论采用IADPSG诊断标准后,GDM检出率明显增高,通过严格控制孕期血糖,可以明显改善母婴结局。
Objective To analyze the application of different diagnostic criteria of gestational diabetes mellitus (gestational diabetes mellitus, gestational diabetes mellitus, gestational diabetes mellitus, gestational diabetes mellitus, gestational diabetes mellitus, explore the more suitable diagnostic criteria of GDM in the region. Methods A total of 651 pregnant women of perinatal health care clinics in the First Hospital of Henan Province were enrolled. Among them, 301 cases were treated as observation group, GDM was diagnosed by International Pregnancy and Diabetes Mellitus Organization (IADPSG), 350 cases as control group, GDM standard step-by-step diagnosis of GDM, comparison of GDM incidence and pregnancy outcomes in both groups of pregnant women. Results The detection rate of GDM was 13.20% in the observation group and 5.14% in the control group, the difference was statistically significant (P <0.05). In the perinatal outcome, the macrosomia and neonatal respiratory distress syndrome, The incidence of preterm birth and fetal growth restriction were all higher in the observation group than in the observation group (P <0.05). There was no significant difference in the incidence of fetal malformation between the two groups (P> 0.05). The incidence of pregnancy-induced hypertension, amniotic fluid hyperplasia, cesarean section rate, puerperal infection and postpartum hemorrhage in both groups were significantly higher than those in the observation group (P <0.05). Conclusion The detection rate of GDM is significantly increased after using IADPSG diagnostic criteria. By strictly controlling blood glucose during pregnancy, the outcome of maternal and infant can be significantly improved.