中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2009年
11期
801-804
,共4页
陈海天%王子莲%胡明晶%李铭岚%祝文晶%刘斌
陳海天%王子蓮%鬍明晶%李銘嵐%祝文晶%劉斌
진해천%왕자련%호명정%리명람%축문정%류빈
血糖%葡糖耐量试验%妊娠并发症%高血糖症%妊娠结局%体重与身体测量%婴儿%新生
血糖%葡糖耐量試驗%妊娠併髮癥%高血糖癥%妊娠結跼%體重與身體測量%嬰兒%新生
혈당%포당내량시험%임신병발증%고혈당증%임신결국%체중여신체측량%영인%신생
Blood glucose%Glucose tolerance test%Pregnancy complications%Hyperglycemia%Pregnancy outcome%Body weights and measures%Infant%newborn
目的 探讨妊娠期单纯葡萄糖筛查试验(GCT)异常对妊娠结局和新生儿体质指标的影响.方法 收集2006年11月至2007年12月于中山大学附属第一医院妇产科住院分娩的孕妇214例,于孕24～28周时行50 g GCT,若服糖后1 h血糖≥7.8 mmol/L,再行75 g口服葡萄糖耐量试验(OGTT),空腹血糖及服糖后1 h、2 h、3 h血糖标准分别为5.3 mmol/L、10.0 mmol/L、8.6 mmol/L和7.8 mmol/L,4项血糖值均未达到上述标准,为OGTT正常.50 g GCT异常、但75 g OGTY正常的116例孕妇及其新生儿为单纯GCT异常组;50 g GCT正常的98例孕妇及其新生儿为GCT正常组.对两组母儿结局进行分析.记录两组新生儿的出生体重、身长、头围、肩周围值;于出生后24 h内以皮尺测定其上臂围,以直尺测定其肱三头肌皮褶厚度及腹壁皮下脂肪厚度.结果 (1)两组母儿结局:单纯GCT异常组孕妇的阴道助产率[10.3%(12/116)]、羊水过多发生率[5.2%(6/116)]、胎膜早破发生率[13.8%(16/116)]、胎儿窘迫发生率[20.7%(24/116)]与GCT正常组[分别为4.1%(4/98)、10.2%(10/98)、17.3%(17/98)、13.3%(13/98)]比较,差异均无统计学意义(P＞0.05);单纯GCT异常组孕妇的剖宫产率[72.4%(84/116)]、阴道顺产率[17.2%(20/116)]、大于胎龄儿出生率[25.9%(30/116)],与GCT正常组[分别为51.0%(50/98)、44.9%(44/98)、6.1%(6/98)]比较,差异均有统计学意义(P＜0.05).(2)新生儿体质指标:单纯GCT异常组新生儿出生体重为(3.4±0.4)kg,与GCT正常组的(3.3±0.4)kg比较,差异有统计学意义(P＜0.05);单纯GCT异常组新生儿身长[(49.9±1.3)cm]、头围[(33.4±1.5)cm]、肩周围[(35.4±2.3)cm]、上臂围[(11.0±0.7)cm]、肱三头肌皮褶厚度[(9.7±1.0)mm]、腹壁皮下脂肪厚度[(7.2±1.2)mm]等体质指标,与GCT正常组[分别为(49.7±1.4)cm、(33.8±1.7)cm、(35.0±2.3)cm、(10.9±0.8)cm、(9.9±1.4)mm、(7.2±1.0)mm]比较,差异均无统计学意义(P＞0.05).结论 单纯GCT异常对新生儿体质指标无影响,但GCT异常的孕妇剖宫产率、大于胎龄儿出生率、新生儿出生体重均高于GCT正常的孕妇.
目的 探討妊娠期單純葡萄糖篩查試驗(GCT)異常對妊娠結跼和新生兒體質指標的影響.方法 收集2006年11月至2007年12月于中山大學附屬第一醫院婦產科住院分娩的孕婦214例,于孕24～28週時行50 g GCT,若服糖後1 h血糖≥7.8 mmol/L,再行75 g口服葡萄糖耐量試驗(OGTT),空腹血糖及服糖後1 h、2 h、3 h血糖標準分彆為5.3 mmol/L、10.0 mmol/L、8.6 mmol/L和7.8 mmol/L,4項血糖值均未達到上述標準,為OGTT正常.50 g GCT異常、但75 g OGTY正常的116例孕婦及其新生兒為單純GCT異常組;50 g GCT正常的98例孕婦及其新生兒為GCT正常組.對兩組母兒結跼進行分析.記錄兩組新生兒的齣生體重、身長、頭圍、肩週圍值;于齣生後24 h內以皮呎測定其上臂圍,以直呎測定其肱三頭肌皮褶厚度及腹壁皮下脂肪厚度.結果 (1)兩組母兒結跼:單純GCT異常組孕婦的陰道助產率[10.3%(12/116)]、羊水過多髮生率[5.2%(6/116)]、胎膜早破髮生率[13.8%(16/116)]、胎兒窘迫髮生率[20.7%(24/116)]與GCT正常組[分彆為4.1%(4/98)、10.2%(10/98)、17.3%(17/98)、13.3%(13/98)]比較,差異均無統計學意義(P＞0.05);單純GCT異常組孕婦的剖宮產率[72.4%(84/116)]、陰道順產率[17.2%(20/116)]、大于胎齡兒齣生率[25.9%(30/116)],與GCT正常組[分彆為51.0%(50/98)、44.9%(44/98)、6.1%(6/98)]比較,差異均有統計學意義(P＜0.05).(2)新生兒體質指標:單純GCT異常組新生兒齣生體重為(3.4±0.4)kg,與GCT正常組的(3.3±0.4)kg比較,差異有統計學意義(P＜0.05);單純GCT異常組新生兒身長[(49.9±1.3)cm]、頭圍[(33.4±1.5)cm]、肩週圍[(35.4±2.3)cm]、上臂圍[(11.0±0.7)cm]、肱三頭肌皮褶厚度[(9.7±1.0)mm]、腹壁皮下脂肪厚度[(7.2±1.2)mm]等體質指標,與GCT正常組[分彆為(49.7±1.4)cm、(33.8±1.7)cm、(35.0±2.3)cm、(10.9±0.8)cm、(9.9±1.4)mm、(7.2±1.0)mm]比較,差異均無統計學意義(P＞0.05).結論 單純GCT異常對新生兒體質指標無影響,但GCT異常的孕婦剖宮產率、大于胎齡兒齣生率、新生兒齣生體重均高于GCT正常的孕婦.
목적 탐토임신기단순포도당사사시험(GCT)이상대임신결국화신생인체질지표적영향.방법 수집2006년11월지2007년12월우중산대학부속제일의원부산과주원분면적잉부214례,우잉24～28주시행50 g GCT,약복당후1 h혈당≥7.8 mmol/L,재행75 g구복포도당내량시험(OGTT),공복혈당급복당후1 h、2 h、3 h혈당표준분별위5.3 mmol/L、10.0 mmol/L、8.6 mmol/L화7.8 mmol/L,4항혈당치균미체도상술표준,위OGTT정상.50 g GCT이상、단75 g OGTY정상적116례잉부급기신생인위단순GCT이상조;50 g GCT정상적98례잉부급기신생인위GCT정상조.대량조모인결국진행분석.기록량조신생인적출생체중、신장、두위、견주위치;우출생후24 h내이피척측정기상비위,이직척측정기굉삼두기피습후도급복벽피하지방후도.결과 (1)량조모인결국:단순GCT이상조잉부적음도조산솔[10.3%(12/116)]、양수과다발생솔[5.2%(6/116)]、태막조파발생솔[13.8%(16/116)]、태인군박발생솔[20.7%(24/116)]여GCT정상조[분별위4.1%(4/98)、10.2%(10/98)、17.3%(17/98)、13.3%(13/98)]비교,차이균무통계학의의(P＞0.05);단순GCT이상조잉부적부궁산솔[72.4%(84/116)]、음도순산솔[17.2%(20/116)]、대우태령인출생솔[25.9%(30/116)],여GCT정상조[분별위51.0%(50/98)、44.9%(44/98)、6.1%(6/98)]비교,차이균유통계학의의(P＜0.05).(2)신생인체질지표:단순GCT이상조신생인출생체중위(3.4±0.4)kg,여GCT정상조적(3.3±0.4)kg비교,차이유통계학의의(P＜0.05);단순GCT이상조신생인신장[(49.9±1.3)cm]、두위[(33.4±1.5)cm]、견주위[(35.4±2.3)cm]、상비위[(11.0±0.7)cm]、굉삼두기피습후도[(9.7±1.0)mm]、복벽피하지방후도[(7.2±1.2)mm]등체질지표,여GCT정상조[분별위(49.7±1.4)cm、(33.8±1.7)cm、(35.0±2.3)cm、(10.9±0.8)cm、(9.9±1.4)mm、(7.2±1.0)mm]비교,차이균무통계학의의(P＞0.05).결론 단순GCT이상대신생인체질지표무영향,단GCT이상적잉부부궁산솔、대우태령인출생솔、신생인출생체중균고우GCT정상적잉부.
Objective To evaluate the influences of abnormal glucose challenge test (GCT) on pregnancy outcomes and neonatal anthropometric data in women with normal oral glucose tolerance test (OGTT).Methods Totally 214 women who delivered in the First Affiliated Hospital of Sun Yat-sen University from November 2006 to December 2007 were enrolled.50 g GCT was performed at 24-28 weeks of gestation and 75 g OGTT would be followed if GCT≥7.8 mmol/L.Those patients,whose OGTT results below the following criteria (5.3 mmoL/L,10.0 mmol/L,8.6 mmol/L,7.8 mmol/L),were classified as normal OGTT.Altogether,116 of the 214 women with abnormal GCT and normal OGTT were collected as the study group and the rest 98 women with normal GCT as the control group.The pregnant outcomes of the two groups were analyzed.The neonatal anthropometry,including birth weight,body length,head circumference and shoulder circumference,were recorded.Other neonatal anthropometric data,such as upper arm circumference,tricep skinfold thickness and hypodermic fat thickness of abdomen were measured by a tape measure within 24 hours after birth.Results (1) Pregnant outcomes:No significant difference was found in the rate of assisted vaginal delivery,polyhydramnios,premature rupture of membranes and fetal distress between the study and control group[10.3% (12/116) vs 4% (4/98),5.2% (6/116) vs 10% (10/98),13.8% (16/116) vs 17% (17/98),20.7% (24/116) vs 13% (13/98),P ＞0.05,respectively],but the rate of cesarean section,spontaneous vaginal delivery and large for gestational age babies in the study group were different from those of the control[72.4% (84/116) vs 51% (51/98),17.2%(20/116) vs 45% (44/98),25.9% (30/116) vs 6% (6/98),P ＜0.05,respectively].(2)Neonatal anthropometry:The birth weight of the study group was significantly higher than that of the control group[(3.4 ±0.4) kg vs (3.3±0.4) kg,P ＜0.05],but no significant difference was shown in any other neonatal anthropometric results between the study and control group,including body length[(49.9 ±1.3)cm vs (49.7±1.4) cm],head circumference[(33.4±1.5)cm vs (33.8±1.7) cm],shoulder circumference [(35.4±2.3)cm vs (35.0±2.3)cm],upper arm circumference[(11.0±0.7)cm vs (10.9±0.8)cm],tricep skinfold thickness[(9.7±1.0)mm vs (9.9± 1.4)mm]and hypodermic fat thickness of abdomen[(7.2±1.2)mm vs (7.2+1.0)mm;all P＞0.05].Conclusion Women with abnormal GCT alone may have no significant influences on neonatal anthropometric data,but might have more cesarean section,large for gestational age babies,and neonatal birth weight than those women with normal GCT.
