首页|胰岛素泵与基础-餐时胰岛素治疗GDM对新生儿预后的影响

胰岛素泵与基础-餐时胰岛素治疗GDM对新生儿预后的影响

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目的:分析胰岛素泵与基础-餐时胰岛素治疗妊娠期糖尿病(GDM)对新生儿预后的影响.方法:选取2020年5月-2022年12月在宝鸡高新医院妇产科诊治的GDM患者147例,其中胰岛素泵组(72例)给予个体化胰岛素泵治疗,基础-餐时胰岛素组(75例)给予个体化基础-餐时胰岛素治疗,对比两组分娩孕周、治疗后孕期血糖达标及需剖宫产占比,对比两组新生儿1min Apgar评分以及早产儿、早产儿、巨大胎儿、胎儿急性窘迫、新生儿低血糖等围生儿期不良并发症,随访对比两组婴儿3个月、12个月婴儿肥胖情况.结果:两组分娩孕周、治疗后孕期血糖达标占比、需剖宫产占比以及新生儿1min Apgar评分均无差异(P>0.05);胰岛素泵组围生儿期不良并发症(2.8%)低于基础-餐时胰岛素组(12.0%),新生儿出生后12个月,胰岛素泵组发生婴儿肥胖占比(4.2%)低于基础-餐时胰岛素组(14.7%)(均P<0.05).结论:胰岛素泵与基础-餐时胰岛素治疗GDM对患者孕期血糖控制效果相当,胰岛素泵治疗在减少围生儿期不良并发症以及出生后12个月时婴儿肥胖方面优于基础-餐时胰岛素治疗.
Effects of the insulin pump and basal insulin therapy at meal for pregnant women with gestational diabetes mellitus on their neonatal prognosis
Objective:To analyze the effects of the insulin pump and basal insulin therapy at meal for pregnant women with gestational diabetes mellitus(GDM)on their neonatal prognosis.Methods:147 pregnant women with GDM who were diagnosed and treated in the hospital were selected from May 2020 to December 2022,including 72 women who were treated with individualized insulin pump in group A and 75 patients who were treated with individualized basal in-sulin therapy at meal in group B.The gestational weeks at delivery,the proportions of the blood glucose reaching tar-get during pregnancy after treatment and the requiring cesarean section of the women were compared between the two groups.The first minute Apgar score and the rates of the perinatal adverse complications,such as premature infants,macrosomia,fetal acute distress and neonatal hypoglycemiam,of the neonates were compared between the two groups.The obese situation of the infants at 3 and 12 months after born were followed and were compared between the two groups.Results:There were no significant diffrences in the gestational weeks at delivery,the proportions of the nor-mal blood glucose level after treatment during pregnancy and the cesarean section needed,and the neonatal 1 min Ap-gar score of the women between the two groups(P>0.05).The incidence of the neonatal adverse perinatal complica-tions(2.8%)of the women in group A was significantly lower than that(12.0%)of the women in group B.The inci-dence of the infant obesity(4.2%)in group A was significantly lower than that in group B(14.7%)in the 12th month after birth(all P<0.05).Conclusion:The insulin pump therapy for the pregnant women with GDM has the same ef-fectiveness as the basal insulin therapy at meal in controlling their blood glucose level during pregnancy,and which is superior to the basal insulin therapy at meal in the reducing neonatal adverse perinatal complications and the infant obesity in the 12th month after birth.

Gestational diabetes mellitusInsulin pumpBasal insulin therapy at mealBlood glucose level controlGestational weeks at deliveryNeonatal prognosis

徐菊红、胡陇娟、张艳利

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陕西省宝鸡高新医院(721000)

联勤保障部队第九八七医院

妊娠期糖尿病 胰岛素泵 基础-餐时胰岛素 血糖控制 分娩孕周 新生儿预后

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(10)