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目的:通过分析孕前空腹血糖检测与新生儿体重、妊娠期糖尿病(GDM)的发生是否有关,探讨免费孕前查体对于防控GDM和巨大儿发生的意义。方法:回顾性分析2014年2月至2014年11月在潍坊市妇幼保健院、诸城市妇幼保健院进行免费孕前优生健康检查并在查体后6个月内怀孕并分娩的孕妇489例。根据2011年我国妊娠期糖尿病(GDM)诊断卫生行业标准,分为GDM组和正常组。结果:排除孕期有心、肝、肺、肾等重要器官疾病、良性肿瘤(包括卵巢囊肿、子宫肌瘤)及多胎等。分为GDM组和正常组,GDM组的年龄、孕前空腹血糖、体质指数、孕24~28周OGTT空腹血糖、1h血糖、2h血糖等各指标均较正常组的高,差异有统计学意义。新生儿体重GDM组较正常组高,差异有统计学意义(P<0.05)。孕前空腹血糖水平与新生儿体重相关(P<0.05)。孕前6个月内空腹血糖受试者工作曲线(ROC)分析结果显示,孕前6个月内空腹血糖预测GDM发生的ROC曲线下面积是0.645(P<0.05)。结论:孕前健康检查空腹血糖与GDM发生有关,与新生儿体重正相关,孕前健康检查空腹血糖检测对于预测GDM的发生具有一定价值。
OBJECTIVE: To investigate if the fasting blood glucose test before pregnancy is related to the birth weight and gestational diabetes mellitus (GDM), and to explore the significance of free pre-pregnancy examination for prevention and control of GDM and giant macrosomia. Methods: A retrospective analysis of 489 pregnant women with free pre-pregnancy eugenics examination in Weifang Maternal and Child Health Hospital and Zhucheng MCH from February 2014 to November 2014 and pregnancy and childbirth within 6 months after physical examination was retrospectively analyzed. According to the 2011 China’s diagnosis of gestational diabetes mellitus (GDM) health industry standards, divided into GDM group and normal group. Results: Exclusion of pregnancy heart, liver, lung, kidney and other important organ diseases, benign tumors (including ovarian cysts, uterine fibroids) and multiple births and so on. Divided into GDM group and normal group, GDM group age, pre-pregnancy fasting blood glucose, body mass index, gestational 24-28 weeks OGTT fasting blood glucose, 1h blood glucose, 2h blood glucose and other indicators were higher than the normal group, the difference was statistically significant. Neonatal weight GDM group than the normal group, the difference was statistically significant (P <0.05). Pre-pregnancy fasting glucose levels correlated with birth weight (P <0.05). ROC analysis of fasting glucose subjects within the first 6 months of pregnancy showed that the area under the ROC curve for fasting blood glucose predicted GDM during the 6 months prior to pregnancy was 0.645 (P <0.05). Conclusion: The pre-pregnancy health examination of fasting blood glucose is related to the occurrence of GDM and positively correlated with the weight of neonates. The pre-pregnancy health examination of fasting blood glucose test is of certain value in predicting the occurrence of GDM.