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目的探讨新标准下妊娠期糖尿病孕妇孕期体重控制对妊娠结局的影响,寻求新标准下妊娠期糖尿病适宜体重增长范围。方法选取2013年1月—2013年12月本院收治的妊娠期糖尿病患者260例,按孕24周后每周体重增长分组:<0.3kg/周为组1,0.3~0.5kg/周为组2,>0.5kg/周为组3。比较3组在妊娠期并发症(感染、妊娠期高血压、胎膜早破、羊水污染)发生率、巨大儿、低体重儿、新生儿高胆红素血症发生率方面差异。结果组1、组3感染发生率高于组2,差异有统计学意义(P<0.01)。组3妊娠期高血压、胎膜早破、羊水污染发病率高于组1、组2,差异有统计学意义(P<0.01)。巨大儿、新生儿低血糖发生率方面组3高于组1、组2,差异有统计学意义(P<0.01),组1、组2间差异无统计学差异。低体重儿发生率组1明显高于组2、组3,差异有统计学意义(P<0.01)。新生儿高胆红素血症方面3组间未见明显差异。结论 GDM孕妇孕期体重控制对妊娠结局至关重要,孕期体重增加0.3~0.5kg/周可提高妊娠期糖尿病孕妇妊娠结局。
Objective To explore the influence of weight control during pregnancy on the outcome of pregnancy in gestational diabetes mellitus patients under the new criteria and to find out the appropriate range of weight gain for gestational diabetes mellitus under the new standard. Methods 260 cases of gestational diabetes admitted to our hospital from January 2013 to December 2013 were grouped according to the weekly weight gain of 24 weeks pregnant group: <0.3kg / week as the group 1, 0.3 ~ 0.5kg / week as the group 2,> 0.5kg / week for group 3. The incidences of complications in pregnancy (infection, gestational hypertension, premature rupture of membranes, amniotic fluid contamination), incidence of macrosomia, low birth weight infants and neonatal hyperbilirubinemia were compared between the three groups. Results The incidence of infection in group 1 and group 3 was higher than that in group 2, the difference was statistically significant (P <0.01). Group 3 hypertension during pregnancy, premature rupture of membranes, the incidence of amniotic fluid contamination higher than group 1, group 2, the difference was statistically significant (P <0.01). The incidence of hypoglycemia in macrosomia and neonates was higher in group 3 than in group 1 and group 2 (P <0.01), and there was no significant difference in group 1 and group 2 between groups. The incidence of low birth weight group 1 was significantly higher than that of group 2, group 3, the difference was statistically significant (P <0.01). Neonatal hyperbilirubinemia no significant differences between the three groups. Conclusion GDM pregnant women weight control during pregnancy is crucial for the outcome of pregnancy, weight gain during pregnancy 0.3 ~ 0.5kg / week can improve gestational diabetes gestational pregnancy outcomes.