CAJ | 학술논문

目的：比较国际糖尿病与妊娠研究组（ International Association 0f Diabetes in Pregnancv Study Groups， IADPSG）妊娠期糖尿病（ gestational diabetes mellitus，GDM）诊断标准与美国国家糖尿病数据组（ National Diabetes data Group，NDDG）GDM诊断标准下GDM发病率及妊娠结局。方法：选取太原市妇幼保健院2011~2012年分娩的、接受规范的GDM筛查和诊断的非孕前糖尿病产妇5340例，对其病历资料进行回顾性分析，比较两种诊断标准计算的妊娠期糖尿病的发生率及对妊娠结局的影响；以同期妊娠分娩的糖代谢正常孕妇为对照。结果：发病率：NDDG诊断标准下，妊娠期糖尿病的发病率为4．87％，IADPSG诊断标准下发病率为11．7％；2011年该院按照NDDG标准诊治，回顾性将所有孕妇按照IADPSG标准诊断，新增GDM78例未经治疗，与新标准下的非GDM孕妇比较妊娠结局，未经治疗的GDM孕妇妊娠期高血压疾病、子痫前期、羊水过多、剖宫产率、产后出血、巨大儿、新生儿高胆红素血症的发生率明显增高（ P﹤0．05）；2012年该院按照IADPSG标准对GDM进行诊治，其中有123例GDM未达到NDDG标准，子痫前期、剖宫产率、巨大儿发生率明显低于2011年未治疗的新增GDM孕妇（ P﹤0．05）。结论：IADPSG诊断标准降低，可使更多患者被纳入到GDM的规范管理系统中，GDM孕妇经治疗后明显减少了巨大儿及剖宫产率，提示新的诊断标准对母婴保健是有意义的。
목적：비교국제당뇨병여임신연구조（ International Association 0f Diabetes in Pregnancv Study Groups， IADPSG）임신기당뇨병（ gestational diabetes mellitus，GDM）진단표준여미국국가당뇨병수거조（ National Diabetes data Group，NDDG）GDM진단표준하GDM발병솔급임신결국。방법：선취태원시부유보건원2011~2012년분면적、접수규범적GDM사사화진단적비잉전당뇨병산부5340례，대기병력자료진행회고성분석，비교량충진단표준계산적임신기당뇨병적발생솔급대임신결국적영향；이동기임신분면적당대사정상잉부위대조。결과：발병솔：NDDG진단표준하，임신기당뇨병적발병솔위4．87％，IADPSG진단표준하발병솔위11．7％；2011년해원안조NDDG표준진치，회고성장소유잉부안조IADPSG표준진단，신증GDM78례미경치료，여신표준하적비GDM잉부비교임신결국，미경치료적GDM잉부임신기고혈압질병、자간전기、양수과다、부궁산솔、산후출혈、거대인、신생인고담홍소혈증적발생솔명현증고（ P﹤0．05）；2012년해원안조IADPSG표준대GDM진행진치，기중유123례GDM미체도NDDG표준，자간전기、부궁산솔、거대인발생솔명현저우2011년미치료적신증GDM잉부（ P﹤0．05）。결론：IADPSG진단표준강저，가사경다환자피납입도GDM적규범관리계통중，GDM잉부경치료후명현감소료거대인급부궁산솔，제시신적진단표준대모영보건시유의의적。
Objective:To compare gestational Diabetes,gestational Diabetes mellitus( GDM)in diagnostic crite-ria by the International Diabetes and Pregnancy Group,the International Association of Diabetes and Pregnancv Study Groups( IADPSG)with incidence of GDM diagnosis and pregnancy outcome in diagnostic criteria by the national Diabe-tes Data Group( NDDG). Methods:5340 cases of maternal non-diabetes before pregnancy in Taiyuan Hospital Health Center for Women and Children from January 2011 to December 2012 were selected,who were accepted the GDM screening and standard diagnosis,and whose medical records were retrospectively analyzed. The incidence of gestational diabetes and the impact on the pregnancy outcome were compared under two diagnostic standards,as far as the glucose metabolism of pregnancy childbirth normal pregnant women were concerned in the same period as controls. Results:The incidence of NDDG diagnostic criteria was 4 . 87%,the IADPSG gestational diabetes incidence was 11 . 7%;In 2011 all pregnant women in accordance with the IADPSG standard diagnosis and using the NDDG criteria were made a diagnosis and given the treatment;new GDM 78 cases without treatment were compared under the new standard of GDM pregnant with the pregnancy outcomes. Gestational hypertension,preeclampsia,hydramnios,postpartum hemorrhage and macro-somia,cesarean section rate were neonatal significantly higher as well as the incidence of high blood bilirubin for un-treated GDM pregnant women. There was significant difference(P﹤0. 05);According to the IADPSG criteria,in 2012 the treatment of GDM was made a diagnosis,of which 123 cases of GDM NDDG criteria were not achieved. Preeclamp-sia,cesarean section rate,incidence of macrosomia were significantly lower than the untreated new GDM pregnant women in 2011( P﹤0 . 05 ). Conclusion:Lowering IADPSG criteria for the diagnosis can benefit more patients with the specification of the management system by being incorporated in the GDM. The macrosomia and cesarean section rate have been significantly reduced for the GDM pregnant women after treatment prompt. The new diagnostic criteria is meaningful for maternal and infant health care.