摘要目的 探讨A1级妊娠期糖尿病(GDM)孕妇分娩时机与临产方式对母儿结局的影响.方法 回顾性分析本院2015年1月至2017年12月间住院分娩的Priscilla White A1级妊娠期糖尿病患者212例,按照不同分娩孕周分为A组(孕40 ～ 40+6周)和B组(孕39～39+6周),按照不同临产方式分为C组(人工催产组)与D组(自然临产组),分别比较A、B两组与C、D两组母儿并发症发生率及剖宫产率.结果 A、B两组母儿并发症的发生率及剖宫产率比较,差异无统计学意义(P＞0.05).C组产后出血、伤口裂开、产褥感染、剖宫产率明显高于D组,差异有统计学意义(P＜0.05).C组新生儿出现窒息、病理性黄疸、低血糖、早发型败血症率明显高于D组,差异有统计学意义(P＜0.05).结论 对于Priscilla White A1级GDM孕妇,预产期后分娩不增加不良结局,而人工催产会增加不良结局,所以若监测母儿青况良好而且宫颈不成熟者,不必过早催产,可等待至妊娠40+6周自然临产,至妊娠41周仍未能自然临产的孕妇再予催产.

abstractsObjective To investigate the effect of delivery time and artificial induced contractions on maternal and fetal outcomes in A1 stage gestational diabetes mellitus (women).Methods 212 cases of Al stage gestational diabetes mellitus treated at our hospital from January,2015 to December,2017 were selected and were divided into group A (40 ～ 40+6 weeks) and group B (39 ～ 39+6 weeks) according to different gestational weeks,and were divided into group C (artificial parturient group) and group D(spontaneous parturition group) according to different delivery modes.The maternal and fetal outcomes were compared between group A and group B and between group C and group D.Results There were no statistical differences in the incidence of complications and the cesarean section rate between group A and group B (P＞0.05).The rates of postpartum hemorrhage,wound dehiscence,puerperal infection,and cesarean section was significantly higher in group C than in group D (P＜0.05).The incidences of neonatal asphyxia,neonatal pathological jaundice,neonatal hypoglycemia,and early neonatal septicemia was significantly higher in group C than in group D (P＜0.05).Conclusions Pregnant women with gestational diabetes at grade A1 can be pregnant to 40+6 weeks.During this period,if the mother and child are in good conditions,the doctor does not have to intervene too early.After this,if the pregnant woman has no natural labor,the doctor can induce the labor.