Perinatal outcome analysis of different glycosylated hemoglobin levels in gestational diabetes mellitus / 中国基层医药

ABSTRACT

Objective To study and analyze the perinatal outcomes of different glycosylated hemoglobin levels in gestational diabetes mellitus (DM).Methods 53 pregnant women diagnosed gestational diabetes in our hospital were selected as the observation group,and 53 pregnant women without gestational diabetes were selected as the control group.The two groups were followed up to terminate pregnancy.The glycosylated hemoglobin level was detected by HPLC.The postpartum hemorrhage,pregnancy induced hypertension syndrome and urinary tract infection and other complications were compared between the two groups.And the premature delivery,polyhydramnios,fetal macrosomia,intrauterine distress,premature rupture of membranes and other adverse pregnancy outcomes were compared between the two groups.According to the different HbA1 c levels in the observation group,they were divided into group A (HbAlc ＜ =6％),group B (HbAlc between 6.1％ ～ 6.5％),group C (HbAlc between 6.6％ ～7.0％) and group D (HbAlc ＞ 7％),the incidences of adverse pregnancy outcome were compared among four groups.Results The incidence rates of postpartum hemorrhage,pregnancy induced hypertension and urinary system infection of the observation group (18.86％,13.21％,11.32％) were higher than those of the control group (3.77％,1.89％,3.77％),the differences were statistically significant (x2 =11.356,9.179,4.085,all P ＜ 0.05).The incidence rates of premature delivery,polyhydramnios,fetal macrosomia,intrauterine distress,premature rupture of membranes of the observation group (9.43％,9.43％,11.32％,13.21％,15.09％) were higher than those of the control group (1.89％,1.89％,1.89％,3.77％,5.66％),the differences were significant (x2 =5.323,5.323,7.207,5.735,4.781,all P ＜ 0.05).The higher the level of glycosylated hemoglobin,the higher the incidence rates of adverse pregnancy outcomes,such as premature delivery,polyhydramnios,fetal macrosomia,fetal distress.And the incidence rate of premature rupture of membranes had no significant correlation with glycated hemoglobin levels (r =0.955,P ＜ 0.05).Conclusion Glycosylated hemoglobin as an important index of gestational diabetes,its change has great influence on the outcome of pregnancy,HbAl c level higher,adverse pregnancy outcomes and the high incidence of clinical pregnancy,should strengthen the HbAlc test,in order to take timely and effective measures to reduce the incidence of adverse pregnancy outcomes and ensure the safety of mother and child.