本文選題：妊娠期糖尿病 + IADPSG標(biāo)準(zhǔn)�。� 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的探討妊娠期糖尿病與非糖尿病母兒的分娩結(jié)局及相關(guān)影響因素。方法回顧分析2012年10月-2013年10月在我院產(chǎn)科住院行剖宮產(chǎn)或自然分娩的并且在我院進(jìn)行孕期產(chǎn)檢的妊娠期糖尿病產(chǎn)婦的臨床資料,隨機(jī)選取同期住院分娩的非糖尿病產(chǎn)婦作為對(duì)照組,比較兩組產(chǎn)婦一般情況、FBG、 75g-OGTT(1hPG、2hPG)、產(chǎn)前BMI及產(chǎn)婦、新生兒分娩后并發(fā)癥差異,回歸分析引起差異的因素,并通過ROC曲線尋找預(yù)測切點(diǎn)。結(jié)果GDM組185例,對(duì)照組196例。GDM組產(chǎn)婦產(chǎn)前BMI、妊娠期高血壓發(fā)生率、剖宮產(chǎn)率、住院時(shí)間明顯高于對(duì)照組(P0.05), GDM組新生兒分娩孕周小于對(duì)照組(P0.01),新生兒發(fā)生多個(gè)分娩并發(fā)癥的風(fēng)險(xiǎn)、轉(zhuǎn)新生兒科治療率明顯高于對(duì)照組(P0.01)。OGTT 2hPG以及分娩孕周對(duì)新生兒是否發(fā)生多個(gè)分娩并發(fā)癥具有預(yù)測價(jià)值,相應(yīng)的診斷切點(diǎn)為7.84mmol/L(曲線下面積為0.613,95% CI：0.552-0.674,P=0.000)和37周(曲線下面積為0.649,95% CI:0.590-0.708, P=0.000)。Logistic多因素分析提示OGTT 2hPG≥7.84mmol/L(OR值1.899,95%CI為1.158-3.112,p=0.011)、分娩孕周≤37周(OR值3.699,95%CI為2.019-6.778,p=0.000)是胎兒／新生兒發(fā)生2個(gè)以上分娩相關(guān)并發(fā)癥的危險(xiǎn)因素。結(jié)論妊娠期糖尿病增加母嬰不良妊娠結(jié)局的發(fā)生率；妊娠中晚孕OGTT2hPG≥7.84mmol/L使得胎兒／新生兒發(fā)生多個(gè)分娩相關(guān)并發(fā)癥的風(fēng)險(xiǎn)增加1.899倍,分娩孕周≤37周使得胎兒／新生兒發(fā)生2個(gè)以上分娩相關(guān)并發(fā)癥的風(fēng)險(xiǎn)增加3.699倍；OGTT 2hPG≥7.84mmol/L及分娩孕周≤37周可能對(duì)預(yù)測新生兒發(fā)生多個(gè)分娩相關(guān)并發(fā)癥具有一定的預(yù)測價(jià)值。
[Abstract]:Objective to investigate the outcome and related factors of gestational diabetes mellitus (GDM) and non-diabetic mothers and infants. Methods from October 2012 to October 2013, the clinical data of pregnant women with gestational diabetes mellitus (GDM) who were hospitalized in our hospital by cesarean section or natural delivery and who underwent prenatal examination in our hospital were analyzed retrospectively. Non-diabetic parturients who were born in hospital at the same time were randomly selected as the control group. The general conditions of the two groups were compared: FBG, 75g-OGTT1hPG2hPGG, prenatal BMI and parturient, the difference of neonatal complications after delivery, and the factors that caused the difference by regression analysis. The predicted tangent point is found by ROC curve. Results there were 185 cases in GDM group and 196 cases in control group. The incidence of pregnancy-induced hypertension, the rate of cesarean section and the hospitalization time were significantly higher than those in control group (P 0.05). The gestational weeks of newborn in GDM group were lower than that in control group (P 0.01), and the risk of multiple complications occurred in neonates. The rate of conversion to neonatal treatment was significantly higher than that of control group (P 0.01). OGTT 2hPG and gestational weeks of delivery had predictive value for the occurrence of multiple delivery complications in neonates. The corresponding diagnostic cutoff points were 7.84 mmol / L (the area under the curve was 0.61395% CI: 0.552-0.674P0.000) and 37 weeks (the area under the curve was 0.64995% CI: 0.590-0.708). P=0.000).Logistic multivariate analysis showed that OGTT 2hPG 鈮，

本文編號(hào)：1910522