实用医学杂志 ›› 2022, Vol. 38 ›› Issue (11): 1400-1409.doi: 10.3969/j.issn.1006⁃5725.2022.11.018

• 临床研究 • 上一篇    下一篇

妊娠期糖尿病合并妊娠期高血压疾病与剖宫产及新生儿结局的关系

颜丽芳1 腾瑶瑶2 梅珊珊3 金红梅2 热合马依·热合木吐拉2 龙燕3 赵学芹3 曾芳玲3 黄耀刚2 陈海燕4 朱春燕2    

  1. 1 清远职业技术学院护理学院(广东清远511510);2 广州医科大学公共卫生学院(广州511436); 3 广州市妇女儿童医疗中心(广州510623);4 清远市清新区人民医院(广东清远511800)

  • 出版日期:2022-06-10 发布日期:2022-06-10
  • 通讯作者: 朱春燕 E⁃mail:zchyan@163.com
  • 基金资助:
    广东省自然科学基金项目(编号:2021A1515012200,2022A1515011550);广东省普通高校特色创新项目(编号:2021KTSCX094);广州市卫生健康科技项目(编号:20141A011030,20191A011035)

Association of gestational diabetes mellitus complicated with hypertensive disorder during pregnancy with cesarean section and pregnancy outcome

YAN Lifang*,TENG Yaoyao,MEI Shanshan,JIN Hongmei,REHE⁃ MUTULA Rehemayi,LONG Yan,ZHAO Xueqin,ZENG Fangling,HUANG Yaogang,CHEN Haiyan,ZHU Chun⁃ yan.   

  1. Nursing College of Qingyuan Vocational and Technical College,Qingyuan 511510,China

  • Online:2022-06-10 Published:2022-06-10
  • Contact: ZHU Chunyan E⁃mail:zchyan@163.com

摘要:

目的 本研究分析妊娠期糖尿病(GDM)合并妊娠期高血压疾病(HDP)与剖宫产及新生儿结局 的相关性。方法 采用现况调查,选取 2020 年在广州市及清远市的妇产科专科医院产后 42 d 门诊就诊的 2 754 名产妇作为研究对象。采用现场自填问卷收集研究资料。结果 2 754 名产妇中,GDM 450 16.3%),HDP 61人(2.2%),GDM合并HDP 21人(0.8%)。控制产妇年龄、孕次及产次的影响后,GDM、HDP GDM 合并 HDP 产妇的剖宫产风险分别提高 1.31 倍(95%CI:1.05 ~ 1.63)、1.87 倍(95%CI:1.10 ~ 3.19)及 2.74 倍(95%CI:1.11 ~ 6.74);HDP及GDM合并HDP产妇的早产风险分别提高2.51倍(95%CI:1.17 ~ 5.40)和 3.91倍(OR = 3.91,95%CI:1.30 ~ 11.81);GDM合并HDP产妇的低出生体重儿及新生儿高胆红素血症风险分 别提高8.33倍(95%CI:2.54 ~ 27.30)和7.77倍(95%CI:1.63 ~ 37.04)。结论 GDM与HDP共病对产妇剖宫产和 围产儿早产、体质量偏低、高胆红素血症等不良事件的风险产生协同效应。

关键词:

妊娠期糖尿病, 妊娠期高血压疾病, 妊娠期糖尿病合并妊娠期高血压疾病, 剖宫 产, 新生儿结局

Abstract:

Objective To explore the association of gestational diabetes mellitus (GDM)complicated with hypertensive disorder during pregnancy(HDP)with cesarean section and pregnancy outcome. Methods A cross⁃sectional study was carried out among 2 754 puerperae who visited the outpatient clinic for 42 days postpartum in the Obstetrics and Gynecology Hospitals in Guangzhou city and Qingyuan city from January to December 2020. A field questionnaire survey was conducted to collect clinical information. On ⁃the ⁃ spot questionnaire survey was used to collect relevant clinical data. Result Among the 2 754 participants,there were 450 with GDM(16.3%),61 with HDP(2.2%),21 with GDM combined with HDP(0.8%). After controlling maternal age,gravidity and parity,results showed cesarean section delivery was 1.31⁃fold(95%CI:1.05 ~ 1.63),1.87⁃fold(95%CI:1.10 ~ 3.19)and 2.74⁃fold(95%CI:1.11 ~ 6.74),respectively,increased in pregnant women with GDM,HDP and GDM combined with HDP than in those without. Compared with women without GDM or HDP,women with HDP and GDM combined with HDP at a 2.51⁃fold(95%CI:1.17 ~ 5.40)and 3.91⁃fold(OR = 3.91,95%CI:1.30 ~ 11.81)higher risk of premature delivery. Women with GDM combined with HDP increased 8.33⁃fold(95%CI:2.54 ~ 27.23)and 7.77⁃fold(95%CI:1.63 ~ 37.04)risk of low⁃birth⁃weight and neonatal hyperbilirubinemia,respec⁃ tively. Conclusion GDM and HDP comorbidity had a synergistic effect on the risk of maternal cesarean section and perinatal preterm birth,low body weight and hyperbilirubinemia. 

Key words:

gestational diabetes mellitus, hypertensive disorders of pregnancy, gestational diabetes mellitus combined with hypertension of pregnancy disease, cesarean section, neonatal outcome