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目的:探讨妊娠合并糖尿病对母婴的危害。方法:回顾性分析2008年1~12月住院分娩的妊娠合并糖尿病患者60例,比较糖尿病合并妊娠组与妊娠期糖尿病(GDM)组的母儿预后以及胎龄与新生儿病率的关系。结果:糖尿病合并妊娠组的妊娠高血压疾病、FGR、胎儿窘迫、新生儿心血管畸形及围产儿死亡率均高于GDM组(P<0.05);GDM组的巨大儿、羊水过多及剖宫产率均高于糖尿病合并妊娠组(P<0.05);胎龄<37周及>40周与胎龄37~40周比较,新生儿病率明显升高(P<0.01);剖宫产与阴道分娩比较,新生儿窒息率明显下降(P<0.01)。结论:妊娠合并糖尿病对母婴危害巨大。对糖尿病合并妊娠者应加强孕前内科治疗,对所有孕妇于24~28周行50g糖筛查,对高危孕妇于32~34周复查可及早诊断妊娠期糖尿病,孕36周始促胎肺治疗可降低新生儿病率;分娩时间以妊娠37~40周为宜,剖宫产对母儿相对安全。
Objective: To investigate the risk of maternal and neonatal pregnancy complicated with diabetes. Methods: A retrospective analysis of 60 cases of pregnant women with diabetes mellitus admitted to hospital from January to December in 2008 was conducted to compare the relationship between maternal and neonatal prognosis, gestational age and neonatal morbidity in diabetic patients with gestational diabetes mellitus (GDM). Results: The incidences of pregnancy-induced hypertension, FGR, fetal distress, neonatal cardiovascular malformations and perinatal mortality in diabetic patients with pregnancy were significantly higher than those in GDM patients (P <0.05). In GDM group, macrosomia, polyhydramnios and cesarean section (P <0.05). The neonatal morbidity was significantly higher in gestational age <37 weeks and> 40 weeks than in gestational age 37 ~ 40 weeks (P <0.01). Cesarean section and Compared with vaginal delivery, neonatal asphyxia decreased significantly (P <0.01). Conclusion: Pregnancy with diabetes is very harmful to mothers and infants. For patients with diabetes mellitus with pregnancy should strengthen pre-pregnancy medical treatment, all pregnant women in the 24 to 28 weeks 50g sugar screening for high-risk pregnant women in 32 to 34 weeks review early diagnosis of gestational diabetes, 36 weeks of pregnancy to promote fetal lung can be treated Reduce neonatal morbidity; delivery time to gestational 37 to 40 weeks is appropriate, cesarean section is relatively safe for the mother and child.