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目的研究妊娠期糖尿病(GDM)患者产后糖代谢转归,比较产后糖代谢正常组与异常组病例的临床特征。方法收集2015年产后6~8周在福建省妇幼保健院产后门诊行糖耐量检查的GDM孕妇888例,分析其产前检查、分娩及产后随访的临床资料。结果 888例中,产后糖代谢正常687例(77.4%),异常201例(22.6%),其中糖尿病24例(2.7%)、空腹血糖受损4例(0.5%)、糖耐量受损142例(16.0%)。产后糖代谢异常组年龄、孕次、孕早期空腹血糖、甘油三酯、孕期(24~28周)糖耐量值和糖化血红蛋白值均较正常组高;两组孕妇的产次、孕前体重指数及孕期增加体重差异无统计学意义,孕早期胆固醇值差异无统计学意义。结论产后6~8周,有22.6%的产妇仍存在糖代谢异常;孕早期空腹血糖、甘油三酯高,孕期糖耐量较高、糖化血红蛋白高等是产后糖代谢异常组的主要特征。
Objective To study the outcome of postpartum glycometabolism in patients with gestational diabetes mellitus (GDM) and to compare the clinical features of patients with normal and abnormal glucose metabolism after delivery. Methods A total of 888 GDM pregnant women with postnatal postpartum 6 to 8 weeks postpartum postpartum glucose tolerance test in our hospital were collected. The clinical data of prenatal examination, delivery and postnatal follow-up were analyzed. Results Among 888 cases, 687 cases (77.4%) had normal postpartum glucose metabolism and 201 cases (22.6%) had abnormal glucose metabolism, including 24 cases of diabetes (2.7%), 4 cases of impaired fasting glucose (0.5%), 142 cases of impaired glucose tolerance (16.0%). The incidences of fasting blood glucose, triglycerides, glucose tolerance and glycosylated hemoglobin (HbA1c) values in the group with abnormal glucose metabolism after birth were significantly higher than those in the normal control group. The birth weight, body mass index before pregnancy, No significant difference in weight gain during pregnancy, cholesterol levels in early pregnancy no significant difference. Conclusion There are 22.6% pregnant women with abnormal glucose metabolism during the first 6 to 8 weeks postpartum. Fasting blood glucose, high triglyceride, high glucose during pregnancy and high glycosylated hemoglobin in early pregnancy are the main characteristics of postpartum abnormal glucose metabolism group.