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多囊卵巢综合征合并妊娠期糖尿病的临床特点分析
Clinical characteristics of gestational diabetes mellitus women with polycystic ovary syndrome
【摘要】 目的探讨多囊卵巢综合征(PCOS)合并妊娠期糖尿病(GDM)的临床特点。方法2006年2月至2008年5月在北京妇产医院诊断的PCOS合并GDM孕妇28例作为研究对象,将同期诊断无PCOS的GDM孕妇60例以及75g糖耐量试验正常(NGT)的孕妇60例作为对照组。比较3组的孕前一般情况,血糖、血脂及胰岛素抵抗情况及围产结局。结果PCOS组孕前BMI(26.33±3.89)明显高于单纯GDM和NGT组,差异有统计学意义(P均<0.01)。PCOS组孕前超重率(71.42%)、不良孕史发生率(35.71%)、使用体外受精-胚胎移植(IVF-ET)技术例数(8例)明显高于单纯GDM,差异有统计学意义(P分别为<0.01、<0.05、<0.01)。PCOS组诊断孕周(22.78±5.23)较单纯GDM组平均提前3.74周,两组比较有统计学意义,P<0.05。PCOS组孕妇平均空腹胰岛素水平(20.66±10.04)mU/L明显高于单纯GDM组(15.11±6.9)mU/L,P<0.01。3组均无胎死宫内及新生儿畸形发生,子痫前期、早产、巨大儿、胎膜早破,新生儿低血糖等的发生率无统计学意义,P>0.05。结论PCOS合并GDM孕妇,经过合理治疗围产期母儿并发症发生率并无明显增加。
【Abstract】 Objective To investigate clinical characteristics of gestational diabetes mellitus(GDM) women with polycystic ovary syndrome.Methods Twenty-eight GDM women with PCOS were considered as the study group from Feb,2006 to May,2008 in Beijing Obstetrics and Gynecology Hospital;60 GDM women without PCOS and 60 pregnant women with normal oral glucose tolerance test(NGT) were considered as the control groups.We compared pre-pregnancy clinical data,fasting glucose,fasting serum insulin,blood lipid,HOMA-IR and perinatal outcomes among the three groups.Results Pre-pregnancy BMI was significantly higher in the study group,compared to the two control groups(P<0.01).There was statistical significance in prevalence of pre-pregnancy overweight,poor pregnancy history(infertility,early pregnancy loss) and using IVF-ET numbers among three groups,P<0.01,P<0.05,P<0.01 respectively.GDM women had fewer gestational weeks than GDM women without PCOS,P<0.05.Serum concentrations of Fins were higher in GDM women with PCOS compared with those without PCOS,P<0.01.No statistical significances were found in fetal death and neonatal congenital abnormality,preeclampsia,premature delivery,macrosomia and so on among the three groups,P>0.05.Conclusion Perinatal complications of mothers and infants are not significantly increased through proper management in GDM women with PCOS.
【Key words】 diabetes mellitus,pregnancy; polycystic ovarian syndrome; perinatal outcomes;
- 【文献出处】 中国实用妇科与产科杂志 ,Chinese Journal of Practical Gynecology and Obstetrics , 编辑部邮箱 ,2009年05期
- 【分类号】R714.2
- 【被引频次】10
- 【下载频次】385