目的:調查台灣區域級以上醫院妊娠糖尿病之周産期預後。方法:1998年7月接受周産期醫學會委託,收集1996年在台灣區域級以上有代表性的醫院之妊娠糖尿病孕婦,以規劃好之調查表郵寄各大醫院婦産科填寫。然後就收集之資料,分析孕産婦以及新生兒之周産期預後。結果:在台灣區域級以上有代表性的八家醫院之妊娠糖尿病(GDM)發生率爲2.03%,妊娠葡萄糖耐性不良(G-IGT)發生率爲6.99%。妊娠糖尿病新生兒較易出現巨嬰,低血糖和呼吸窘迫症候群。妊娠葡萄糖耐性不良新生兒也易出現低血糖現象。討論:台灣孕期糖尿病生兒罹病率比一般孕婦高,在周産期照護上不能輕忽之。
Objective: To compare the pregnancy outcomes between women with glucose intolerance and women in the general obstetric population of Taiwan. Methods: In July 1998, questionnaires were mailed to a large number of representative medical centers and community hospitals across Taiwan. Available data from eight hospitals were analyzed by Pearson X^2 or Fisher's exact tests as appropriate. Neonatal complications analyzed included macrosomia, hypoglycemia, hyperbilirubinemia, NICU admission and respiratory distress syndrome. Maternal complications analyzed included PIH (pregnancy induced hypertension), stillbirth, IUGR (intrauterine growth restriction) and preterm delivery. Results: GDM (gestational diabetes mellitus) screening in Taiwan has shown that the incidence of GDM to be 2.03%. G-IGT (gestational-impaired glucose tolerance) is present in the population at 6.99%. The adverse outcomes associated with GDM were macrosomia (7.17% vs. 2.01%), respiratory distress syndrome (3.57% vs. 0.52%) and hypoglycemia (12.5% vs. 0.25%). Perinatal mortality was not increased, but women with GDM had a higher rate of pregnancy induced hypertension (19.7% vs. 4.71%) and preterm delivery(24.4% vs. 6.30%). Discussion: GDM screening is well established using a 50gm, 1-hour oral glucose load and is carried out between the 24 and 28 weeks of gestation in Taiwan. The women with glucose intolerance during pregnancy have a higher risk of maternal and neonatal morbidity than the general population in Taiwan.