Clinical Analysis: 92 Cases Of Pregnancy Associated With Diabetes

Pregnancy associated with diabetes includes gestational diabetes mellitus(GDM) in which diabetes is diagnosed or found for the first time during pregnancy and also the cases that diabetes complicated with pregnancy, both of which have the characteristic of glycometabolism disorder. Recently it has been paid a lot of close attention because of its increasing incidence rate. Gestational glycometabolism has its own complicated feature such as physiological Insuline resistance(IR) existing in almost everyone, but it will lead to GDM eventually only if no extra-insulin is excreted as compensation. To the patients who have diabetes complicated with pregnancy controlling of blood sugar level will become much more difficult. It has maternal and perinatal infants serious and far-reaching influence, even extended to 20 years after the end of pregnancy. Therefore, the strengthening of early maternal blood sugar screening, regulating blood glucose management during pregnancy should be the key point for decreasing perinatal complications of expectant mother and neonatal and also improve obstetrical qualitative.Object: To investigate the high risk factors of pregnancy associated with diabetes and the severe impact to expectant mother and her neonatal.Method: According to the standard of National Diabetes Data Group (NDDG) 92 cases of pregnancy associated with diabetes from inpatient hospital during January 1999 to January 2008 from the First Hospital of Jilin University are retrospectively analyzed. While 90 cases with normal glucose tolerance are selected randomly over the same period in the control group. All the collected clinical data is compared and analyzed statistically with SPSS 12.0 software, admitted P<0.05 is significant.Result: Compared to the control group the incidence of family history of diabetes, senior pregnant woman(age≥30 years old), high BMI, history of adverse pregnancy and the occurrence of multiple pregnancies is significantly higher while gestational age and birth significantly less(P<0.05). Meanwhile comparing the two groups, the incidence of pregnancy-induced hypertension syndrome, diabetic ketoacidosis, infection, polyhydramnios and the incidence of premature rupture of membranes in study group are significantly higher than that of control group (P<0.05). The impact on the mode of delivery: cesarean section rate in the study group is significantly higher and gestational age is less than the control group, a statistically significant difference (P<0.05). Further more incidence of premature infant, large for date infant, oaf and dean foetus, stillbirth, neonatal respiratory distress syndrome and neonatal hypoglycemia in the control group in study group is significantly higher than that of study group(P<0.05).Conclusion:1.Family history of diabetes,old pregnant woman (age≥30 years old), high pregnancy BMI, history of adverse pregnancy and the occurrence of multiple pregnancies are all high risk factors of pregnancy associated with diabetes. 2. Pregnancy associated with diabetes can cause a variety of obstetric complications such as pregnancy-induced hypertension syndrome, diabetic ketoacidosis, infection, polyhydramnios and the incidence of premature rupture of membranes seriously endangering maternal health. 3. Pregnancy associated with diabetes significantly increase the rate of cesarean section(not including the indication of social factors), at the same time shorten gestational age and increase the iatrogenic preterm infants. 4. Pregnancy associated with diabetes easily lead the adverse outcome of infants such as premature infant, large for date infant, oaf and dean foetus, stillbirth, neonatal respiratory distress syndrome and neonatal hypoglycemia. 5. The screening and early pregnancy diagnosis, standardized management of blood sugar during pregnancy and treatment are important means for improving the outcome of pregnancy and also improving obstetrical qualitative.