应用已制定的妊娠期糖尿病指南对妊娠和分娩结果的影响

E. Elbeltagy, N. Khedr, N. Abd-Ella
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摘要

背景:妊娠期糖尿病(GDM)是妊娠期最常见的医学健康问题之一,可导致一系列短期和长期的母体、胎儿和新生儿并发症。然而,GDM自我保健措施的有效管理和教育可以改善妇女及其新生儿的妊娠结局。目的:探讨应用妊娠期糖尿病指南对妊娠及分娩结局的影响。方法:采用准实验研究设计,在曼苏拉市曼苏拉大学附属医院妇产科专科中心产前门诊进行研究。126名确诊为GDM的孕妇,分为干预组(n = 63)和对照组(n = 63),干预组在常规产前护理的基础上采用妊娠糖尿病指南(GDMG)进行护理,对照组仅采用常规产前护理。工具:使用三种工具收集参与者的数据:结构化访谈时间表、孕产妇评估记录和胎儿及新生儿评估记录。结果:目前的研究结果显示,GDMG组干预后体重指数和妊娠34、37周平均随机血糖水平较对照组有高度统计学意义的降低(p < 0.001)。GDMG组妊娠期高血压、子痫前期、早产、羊水过多等孕产妇并发症发生率均有统计学意义的降低。GDMG组新生儿出生后Apgar评分较高,早产、呼吸窘迫综合征、入住新生儿重症监护病房等新生儿并发症发生率较低。结论和建议:本研究显示,GDM孕妇使用GDMG比未使用GDMG有更好的孕产妇和新生儿结局。建议对所有妊娠期糖尿病孕妇进行手工GDMG,以更好地改变生活方式和维持自我管理方案,并获得更好的妊娠结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes
Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.
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