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目的对3种妊娠期糖尿病的诊断标准及妊娠结局进行比较,并给予临床评价。方法对1 174例孕妇进行血糖筛查试验,阳性者进行葡萄糖耐量试验(OGTT)。按照国际妊娠合并糖尿病研究组(International Association of Diabetes and Pregnancy Study Group,IADPSG)标准、美国国家糖尿病数据组(National Diabetes Date Group,NDDG)标准和国内董志光等标准进行诊断并分组,分析比较3组母婴妊娠结局。结果 IADPSGGDM检出率、NDDG和董志光等标准的GDM+GIGT检出率分别为7.8%(92/1 174)、6.3%(74/1 174)、7.2%(85/1 174),差异无统计学意义(P>0.05)。各GDM组间在胎儿窘迫、剖宫产和妊娠高血综合征的发生率方面差异均无统计学意义(P>0.05),仅IADPSG巨大儿发生率与其他组差异有统计学意义(P<0.05)。结论 GDM需进行早期干预。3种诊断标准妊娠结局差异无统计学意义。2010年IADPSG标准将使更多孕妇纳入诊断,有利于早期干预,减少母婴并发症的发生。
Objective To compare the diagnostic criteria of 3 kinds of gestational diabetes mellitus and pregnancy outcome and give the clinical evaluation. Methods A total of 1 174 pregnant women underwent blood glucose screening test, and those who were positive were tested for glucose tolerance (OGTT). According to the International Association of Diabetes and Pregnancy Study Group (IADPSG) standard, the National Diabetes Date Group (NDDG) standard and the domestic Dong Zhiguang standards for diagnosis and grouping, analysis and comparison of three groups of mother Infant pregnancy outcome. Results The detection rates of IADPSGGDM, NDDG and Dong Zhiguang were 7.8% (92/1 174), 6.3% (74/1 174) and 7.2% (85/1 174) respectively, with no statistical difference Significance (P> 0.05). There was no significant difference in the incidence of fetal distress, cesarean section and gestational hypertension syndrome between GDM groups (P> 0.05), and the incidence of giant IADPSG only had statistical significance compared with other groups (P < 0.05). Conclusion GDM needs early intervention. There was no significant difference in pregnancy outcome between the three diagnostic criteria. 2010 IADPSG standard will make more pregnant women included in the diagnosis, is conducive to early intervention to reduce the incidence of maternal and child complications.