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目的:探讨妊娠期糖尿病(GDM)的两种不同诊断标准对围产期母婴结局的影响。方法:选取2011年5月~2013年5月间在该院进行血糖筛查并分娩的孕产妇9 925例。按照诊断标准的不同分为美国糖尿病学会诊断标准组(A组)4 590例、国际糖尿病与妊娠研究组诊断标准组(B组)5 335例。对比两组孕妇的GDM检出率、分娩方式、妊娠期并发症、新生儿并发症等情况。结果:B组GDM的检出率明显高于A组,差异有统计学意义(P<0.01);A组GDM孕妇阴道分娩比例明显低于B组,剖宫产比例明显高于B组,差异均有统计学意义(P<0.05);A组GDM孕妇中羊水过多、胎膜早破的发生率明显高于B组,差异均有统计学意义(P<0.05);A组GDM孕妇中巨大儿、新生儿窒息、新生儿低血糖的比例明显高于B组,差异均有统计学意义(P<0.05)。结论:国际糖尿病与妊娠研究组的诊断标准能够有效提高GDM检出率,改善母婴结局。
Objective: To investigate the effect of two different diagnostic criteria of gestational diabetes mellitus (GDM) on perinatal maternal and infant outcomes. Methods: A total of 9 925 pregnant women were enrolled in this study from May 2011 to May 2013. According to the diagnostic criteria, there were 4 590 cases in the American Diabetes Association diagnostic criteria group (group A) and 5 335 cases in the international Diabetes and Pregnancy Study Group diagnostic criteria group (group B). Compare the GDM detection rate, mode of delivery, pregnancy complications, neonatal complications in two groups of pregnant women. Results: The detection rate of GDM in group B was significantly higher than that in group A (P <0.01). The proportion of vaginal delivery in group A was significantly lower than that in group B, and the proportion of cesarean section was significantly higher than that in group B (P <0.05). The incidence of amniotic fluid hyperplasia and premature rupture of membranes in group A were significantly higher than that in group B (P <0.05). In group A, the number of pregnant women with GDM was significantly higher than that in group B Huge children, neonatal asphyxia, neonatal hypoglycemia was significantly higher than the proportion of B group, the difference was statistically significant (P <0.05). Conclusion: The diagnostic criteria of the International Diabetes and Pregnancy Study Group can effectively improve the detection rate of GDM and improve the maternal and infant outcomes.