妊娠期糖尿病妇女产后转归及随访的研究进展

刘铭忆; 马秀华

doi:10.16766/j.cnki.issn.1674-4152.002289

妊娠期糖尿病妇女产后转归及随访的研究进展

doi: 10.16766/j.cnki.issn.1674-4152.002289

刘铭忆¹,
马秀华^2, ,

1.
首都医科大学大兴教学医院全科医学科，北京 102600
2.
首都医科大学大兴教学医院妇产科，北京 102600

详细信息

通讯作者:
马秀华，E-mail：mxhdxqyy@126.com

中图分类号: R714.256 R715.3
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- 文章访问数: 440
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- PDF下载量: 23
- 被引次数: 0
出版历程
- 收稿日期: 2020-06-27
- 网络出版日期: 2022-03-03

Advance in research on postpartum outcome and follow-up of women with gestational diabetes mellitus

LIU Ming-yi¹,
MA Xiu-hua^{2
, ,}

1.
School of General Practice Continuing Education, Capital Medical University, Beijing 100069, China

摘要

摘要: 妊娠期糖尿病(gestational diabetes mellitus，GDM)是一种在怀孕期间发现葡萄糖耐量异常的疾病，此时胰腺β细胞无法代偿逐步增加的胰岛素抵抗, 是妊娠期常见的并发症。孕期高血糖会导致母儿近期和远期不良结局。在妊娠早期可能引起畸形、死胎、流产。妊娠晚期可发生巨大儿、剖宫产、肩部难产、新生儿转儿科和新生儿低血糖等不良结果，研究还表明，GDM与孕妇长期并发症(如2型糖尿病和心血管疾病)、中枢性肥胖、高甘油三酯血症、低HDL水平和高血压有关。血糖控制显示可改善随后妊娠中GDM复发的风险。随着生活方式的转变和经济的发展，妊娠期糖尿病发病率增加，虽然国内外相关指南推荐产后随访时行血糖筛查，但各指南推荐的筛查时间和方式不统一。产后筛查存在多种障碍，医生未告知患者应产后复查血糖，妇女无法获得葡萄糖测试。目前妊娠期糖尿病妇女产后随访率低导致难以及时管理，产后血糖恢复不理想。妊娠期糖尿病孕妇在分娩后出院前完成血糖筛查、产后及时提醒、重视对患者的宣教、提高医务人员责任意识可以改善妊娠期糖尿病妇女产后随访现状，并及时提供相应的干预，改善她们未来的结局。本文就妊娠期糖尿病妇女产后转归及随访的研究进展进行综述。
- 妊娠期糖尿病 /
- 糖尿病 /
- 产后 /
- 妊娠 /
- 筛查
Abstract: Gestational diabetes mellitus (GDM) is a condition in which glucose intolerance is initially recognised during pregnancy, when the progressive increases in insulin resistance cannot be adequately accommodated by an additional pancreatic β-cell response, and it is a common complication during pregnancy. Hyperglycaemia during pregnancy can lead to adverse short-term and long-term outcomes for the mother and child. It may cause deformity, stillbirth and miscarriage in the early pregnancy. In the late pregnancy, undesirable results such as giant babies, caesarean section, shoulder dystocia, neonatal transfer to paediatrics and neonatal hypoglycaemia can occur. In addition, GDM is associated with an increased risk for long-term maternal complications such as type 2 diabetes mellitus and cardiovascular disease and components of metabolic syndrome, including central obesity, hypertriglyceridemia, low HDL levels and hypertension. Glycaemic control can modify the risk for GDM recurrence in subsequent pregnancy. With the change of lifestyle and the development of economy, the prevalence of GDM increases. Although relevant domestic and foreign guidelines recommend blood glucose screening during postpartum follow-up, the time and method of screening recommended by each guideline are not uniform. Multiple barriers are identified when receiving postpartum screening, such as the lack of a physician order for the postpartum glucose test and failure by the woman to obtain the glucose test. The follow-up rate is generally low, which makes timely management of high-risk women difficult. Moreover, the postpartum results are not optimistic. Complete blood glucose screening amongst pregnant women with gestational diabetes before discharge after delivery, reminding after delivery timely, paying attention to the propaganda and education of patients and enhancing the responsibility awareness of doctor can improve the postpartum follow-up status of women with gestational diabetes and provide interventions to improve their future outcomes. This paper reviews the research progress of postpartum outcome and follow-up of women with GDM.
- Gestational diabetes mellitus /
- Diabetes mellitus /
- Postpartum /
- Pregnancy /
- Screening

HTML全文

表 1 相关文献中妊娠期糖尿病妇女的产后转归现状及随访率

作者	研究例数	随访	糖代谢异常	糖尿病前期	糖尿病
李爱玲等^[5]	215		101(47.0)	86(40.0)	15(7.0)
毋晶等^[6]	96		42(43.8)	29(30.2)	13(13.5)
丁文静等^[7]	611		203(33.2)	144(23.6)	59(9.7)
林莹等^[8]	2 586	1 362(55.4)	303(22.3)	271(19.9)	32(2.3)
LIU H等^[9]	1 263		484(38.3)	401(32.0)	83(6.6)
BATTARBEE A N等^[10]	683	279(40.8)
EL OUAHABI H等^[11]	200	45(22.5)	56(28.0)	26(13.0)	30(15.0)
MAHZARI M M等^[12]	123				82(67.0)

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