论文部分内容阅读
目的探讨妊娠期糖尿病(GDM)及肝内胆汁淤积症(ICP)单胎孕妇对不良母儿结局(PPO)的影响和患者一般情况(年龄、孕产次、辅助生殖)与PPO的关系。方法 2007年1月至2011年12月,在华中科技大学同济医学院附属同济医院产科病房单胎分娩的同时合并GDM及ICP(GDM+ICP)患者8例(GI组)、GDM患者199例(G组)、ICP患者84例(I组),并随机抽取同期单胎分娩的261例无任何妊娠合并症者作为对照组,回顾性分析4组的母儿结局。结果 (1)GDM+ICP(同时合并GDM和ICP)、GDM、ICP的发生率分别为0.08%、1.92%、0.81%;(2)消除其它因素影响的情况下:GI组的产后出血(PPH)、巨大儿(LGA)、先兆子痫(PE)、早产(PTL)、剖宫产(CS)发生风险分别约为对照组的19、37、25、29、8倍;G组LGA、围生儿死亡(PM)、PE、PTL的发生风险分别约为对照组的41、4、5、9倍;I组LGA、PE、PTL、CS的发生风险分别约为对照组的13、5、11、8倍;孕妇年龄每增加1岁PM、PTL、CS的发生风险均约增加1倍;孕次每增加1次,胎儿窘迫(FD)发生风险将约增加2倍;辅助生殖技术(ART)受孕者PE和PTL的发生风险分别约为正常受孕者的4倍和2倍;其它因素对不良围生期结局(PPO)的发生无明显影响。结论合并GDM及ICP的孕妇PPH、LGA、PM、PE、PTL及CS的发生风险明显高于正常孕妇;ART受孕者PE和PTL发生风险增加;随孕妇年龄、孕次和产次的增加,其PM、FD和PPH发生风险亦增加。
Objective To investigate the effect of gestational diabetes mellitus (GDM) and intrahepatic cholestasis (ICP) singleton pregnant women on adverse maternal outcome (PPO) and the relationship between PPO and general condition (age, pregnancy rate, assisted reproductive). Methods From January 2007 to December 2011, 8 patients with GDM and ICP (GDM + ICP) combined with single childbirth in the obstetric ward of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were grouped into 8 groups (GI group) and 199 GDM patients G group) and 84 patients with ICP (group I). 261 pregnant women without any pregnancy complications were randomly selected as the control group. The maternal and child outcomes of the four groups were retrospectively analyzed. Results (1) The incidences of GDM + ICP (combined GDM and ICP), GDM and ICP were 0.08%, 1.92% and 0.81%, respectively. (2) In the case of other factors, the incidence of postpartum hemorrhage ), The risk of LGA, PE, PTL and CS were about 19, 37, 25, 29 and 8 times of the control group, respectively. In the G group, the LGA, The risk of neonatal death (PM), PE and PTL were about 41, 4, 5 and 9 times that of the control group respectively. The risk of LGA, PE, PTL and CS in group I were about 13, The risk of PTD and CS increased by about 1 time. Each additional dose of gestational age increased the risk of fetal distress (FD) by about 2 times. ART assisted reproductive (ART) ) The risk of developing PE and PTL was about 4 times and 2 times that of normal pregnancy respectively. Other factors had no significant effect on the occurrence of adverse perinatal outcome (PPO). Conclusions The risk of PPH, LGA, PM, PE, PTL and CS in pregnant women with combined GDM and ICP is significantly higher than that in normal pregnant women. The risk of PE and PTL is increased in ART pregnant women. With the increase of pregnant women ’s number of pregnancies and births, The risks of PM, FD and PPH also increased.