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目的妊娠期糖代谢异常可引起新生儿多种并发症。本文通过回顾性分析,探讨妊娠期不同程度糖代谢异常对新生儿的影响。方法根据孕妇口服75g葡萄糖耐量试验(OGTT)的结果将所分娩新生儿分为妊娠期糖尿病组(GDM组)128例及妊娠期糖耐量减低组(GIGT组)130例。根据GDM组患者是否应用胰岛素分为单纯饮食治疗组GDM-A组(67例)和胰岛素治疗组GDM-B组(61例),根据GIGT组患者在不同时点的单向血糖升高分为GIGT(1h)组(60例)、GIGT(2～3h)组(70例),并以糖代谢正常孕妇所分娩新生儿153例作为对照,对妊娠期不同程度糖代谢异常孕母的围产儿结局进行比较。结果①GDM-B组巨大儿、新生儿低血糖、新生儿黄疸及早产儿的发生率均明显高于对照组;GDM-A组早产儿、巨大儿及新生儿黄疸发生率高于对照组;而GDM-B组与GDM-A组新生儿低血糖发生率比较,差异有统计学意义。②GIGT1h组早产儿及新生儿黄疸发生率明显高于对照组;GIGT2～3h组各种并发症发生率与对照组相比差异均无统计学意义;而GIGT1h组与GIGT2～3h组相比,早产儿及新生儿黄疸发生率有明显差异。结论妊娠期不同程度的糖代谢异常对新生儿的影响不同。GDM组虽经系统治疗,但其新生儿并发症发生率仍明显增高,而GDM-B组尤易发生新生儿低血糖;而GIGT组,尤其是GIGT(1h)组增高的新生儿,可导致早产儿及新生儿黄疸发生率的增加。
Objective Abnormal glucose metabolism during pregnancy can cause a variety of neonatal complications. Through retrospective analysis, this article explores the impact of different levels of glucose metabolism during pregnancy on newborns. Methods According to the results of oral glucose tolerance test (OGTT) in pregnant women, 128 newborn infants were divided into gestational diabetes mellitus group (GDM group) and 130 gestational glucose tolerance group (GIGT group). According to whether insulin was used in patients with GDM group, GDM-A group (67 cases) and insulin-treated group GDM-B group (61 cases) were divided into two groups according to GIGT group GIGT group (60 cases) and GIGT (2 ~ 3 hours group) (70 cases), and 153 cases of newborns delivered by normal pregnant women with glucose metabolism were used as controls. The perinatal infants with different levels of glucose metabolism during pregnancy The outcome is compared. Results ① The incidence of hypoglycemia, neonatal jaundice and premature infants in GDM-B group was significantly higher than that in control group. The incidence of jaundice in GDM-A group was higher than that in control group, while GDM - B group and GDM-A group neonatal hypoglycemia incidence rates, the difference was statistically significant. (2) The incidence of jaundice in preterm and neonatal GIGT1h group was significantly higher than that in control group. There was no significant difference in the incidence of various complication between GIGT2 ~ 3h group and control group, while GIGT1h group compared with GIGT2 ~ 3h group Children and neonatal jaundice have significant differences. Conclusion Different degrees of glucose metabolism during pregnancy have different effects on neonates. Although the GDM group was treated by the system, the incidence of neonatal complications was still significantly higher than that of the GDM-B group, while the neonatal hypoglycemia was more likely to occur in the GDMT group, especially in the GIGT (1h) group Preterm infants and newborns increased incidence of jaundice.