分析妊娠期糖代谢异常孕妇产程中血糖水平与新生儿低血糖发生率的关系，探讨妊娠期糖代谢异常孕妇产程中血糖管理的方法及其意义。

选取2002年8月至2007年10月在北京大学第一医院产科分娩的435例孕期确诊为糖代谢异常，并进行产程血糖监测的单胎妊娠孕妇为研究对象。其中，妊娠期糖耐量减低(gestational impaired glucose tolerance,GIGT)组孕妇为206例)(GIGT组)，妊娠期糖尿病A1型(GDMA1)组孕妇为136例(GDMA1组)，妊娠期糖尿病A2型(GDMA2)组孕妇为93例(GDMA2组)。比较三组不同程度妊娠期糖代谢异常孕妇产程中产程随机血糖水平与新生儿低血糖水中发生率的关系。

妊娠期糖耐量减低、妊娠期糖尿病A1型、妊娠期糖尿病A2型三组孕妇所产新生儿低血糖发生率分别为2.9%，2.9%及1.1%，三组间比较，差异无显著意义(P=0.602)。产程随机血糖浓度<7.8 mmol/L的孕妇与产程随机血糖浓度≥7.8 mmol/L(未用胰岛素治疗)的孕妇所产新生儿低血糖发生率比较，GIGT组为3.0∶1.3，GDMA1组为0.0∶1.8,GDMA2组为0∶0，各组内比较，差异无显著意义(P>0. 05);三组新生儿出生后即刻血糖水平与产程平均血糖水平不相关(P=0.260,0. 861及0.296)。

基于孕期的良好治疗和新生儿期的适当处理，妊娠期糖代谢异常孕妇产程中血糖对新生儿低血糖发生的影响有限，对高危新生儿出生后的严密血糖监测、及时喂养，可能具有更重要的临床意义。

To analyze the relationship between maternal blood glucose level and the incidence of neonatal hypoglycemia, and evaluate ways and significances of maternal blood glucose management of gestational diabetes mellitus(GDM)women during labor.

A retrospective analysis was conducted on 435 cases from August 2002 to October 2007 of singleton pregnancy with abnormal gestational glucose tolerance, whose blood glucose levels were monitored during labor, were subdivided into 206 cases with the gestational impaired glucose tolerance group(GIGT group),136 cases and 93 cases with the gestational diabetes mellitus Al(GDMA1 group)and A2 group(GDMA2 group), respectively.

The morbidity of neonatal hypoglycemia in GIGT group, GDMAl group and GDMA2 group was 2.9%,2.9% and 1.1%,respectively(P=0.602). Within the 3 gestational groups of abnormal glucose metabolism, no significant difference was found in the incidence of neonatal hypoglycemia between women with the blood glucose<7.8 mmol/L and those with the blood glucose≥7.8 mmol/L occurring in labor without insulin treatment[the gestational impaired glucose tolerance group was 3% vs.1.3%;the gestational diabetes mellitus Al group was 0% vs.1.8%; the gestational diabetes mellitus A2 group was 0% vs. 0%(P>0.05)]. No correlation was detected between the immediate neonatal blood glucose value at birth and maternal mean blood glucose during labor in 3 groups(P=0. 260, 0.861,0.296).

With strict glycemia control for pregnant women and appropriate management of newborns, maternal hyperglycemia of the women with gestational diabetes mellitus during labor has limited effect on the level and the incidence of neonatal hypoglycemia. Blood glucose assay and immediate feed for high risk neonates might have more clinical importance.