目的   调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况，为区域干预提供依据。方法   将江西省南昌市东湖区划分为东、南、西、北、中5个片区，每个片区随机抽取一个街道（管理处），于每年5月份随机抽取各街道（管理处）20名孕妇，每年共抽取100名孕妇，3年共计300名孕妇，采集其尿液样本和家中食用盐样本检测碘含量，以统计学方法进行分析。结果  3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg，碘盐覆盖率为98.67%，碘盐合格率为95.33%，3年的食用盐碘含量比较差异有统计学意义（H=38.545，P＜0.05）。孕妇的尿碘水平中位数为115.15 μg/mL，3年来孕妇的尿碘水平中位数均低于150 μg/mL，有62.67%的孕妇碘缺乏，3年间的尿碘水平比较差异有统计学意义（H=9.392，P＜0.05），其中2024年的尿碘水平中位数为140.00 μg/mL，校正后高于2022年（Z=2.693，P＜0.0167）和2023年（Z=2.590，P＜0.0167）。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇碘营养状况与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇尿碘水平与碘营养状况正相关（r_s=0.857，P＜0.05），盐碘含量与碘盐质量正相关（r_s=0.314，P＜0.05）。结论   江西省南昌市东湖区2024年孕妇碘缺乏有所改善，但整体形势严峻，超半数的孕妇碘缺乏，食用碘盐基本符合国家消除碘缺乏病标准，但仍需改进。卫生部门要强化孕妇碘营养监测，向孕妇科普碘缺乏病知识，增强补碘意识，促其科学补碘。盐业监管部门需加大监管，严控碘盐质量，确保东湖区居民食盐合格。

       Objective  To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District，Nanchang City，Jiangxi Province from 2022 to 2024，and provide a basis for regional intervention．Methods  Donghu District was divided into five areas：East，South，West，North，and Central．A street（management office）was randomly selected from each area，and 20 pregnant women were randomly selected from each street（management office）in May each year．A total of 100 pregnant women were selected each year，for a total of 300 pregnant women over three years．Urine samples and household salt samples were collected to detect iodine content，and statistical analysis was conducted．Results  Over the past three years，the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg，the iodized salt coverage rate was 98.67%，and the iodized salt qualification rate was 95.33%．There were differences in the iodine content of cooking salt in the three years（H=38.545，P＜0.05）．The median urinary iodine level of pregnant women was 115.15 μg/mL．In the past three years，the median urinary iodine levels of pregnant women were all lower than 150 μg/ml，and 62.67% of pregnant women were iodine-deficient．There were differences in the urinary iodine levels in the three years（H=9.392，P＜0.05）．Among them，the median urinary iodine level in 2024 was 140.00 μg/mL，which was significantly higher than that in 2022（Z=2.693，P＜0.0167）and 2023（Z=2.590，P＜0.0167）after correcting the significance level．Spearman correlation analysis  results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt（all P＞0.05），and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt（all P＞0.05）．The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status（r_s=0.857，P＜0.05），and the iodine content in salt is positively correlated with the quality of iodized salt（r_s=0.314，P＜0.05）．Conclusions  In 2024，the iodine deficiency among pregnant women in Donghu District，Nanchang City，Jiangxi Province was improved，but the overall situation is still severe．More than half of pregnant women were iodine-deficient．The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders，but still needed to be improved．The health department should strengthen the monitoring of iodine nutrition among pregnant women，popularize knowledge about iodine deficiency disorders to pregnant women，enhance their awareness of iodine supplementation，and promote their scientific iodine supplementation．The salt industry supervision department needs to strengthen supervision，strictly control the quality of iodized salt，and ensure that the cooking salt of residents in Donghu District is qualified．

目的 探讨头位分娩评分法在孕妇分娩过程中的应用价值。方法 选取2020年1月—2022年12月于郑州市妇幼保健院进行建档住院的4 000例待产分娩孕妇作为研究对象,所有孕妇在宫口已开时都给予头位分娩评分,观察与记录所有孕妇的分娩方式与头位分娩评分法状况,记录新生儿出生1 min与出生5 min的Apgar评分,记录所有孕妇的产后并发症发生情况。结果 在4 000例孕妇中,Apgar评分≤8分者156例、9~10分者894例、≥11分者2 950例。不同头位分娩评分法孕妇的年龄、孕周、孕次、产次对比差异无统计学意义（P>0.05）。≤8分者的剖宫产率为100.0%,9~10分者、≥11分者分别为35.3%、5.7%,对比差异有统计学意义（P<0.05）。≤8分者、9~10分者、≥11分者的新生儿出生1 min与出生5 min的Apgar评分对比差异无统计学意义（P>0.05）。≤8分者、9~10分者、≥11分者的产后发热、产后出血、产后血肿、产后尿潴留等并发症发生率为分别为13.5%、2.0%、0.2%,对比差异有统计学意义（P<0.05）。结论 头位分娩评分法在产科中处理头位分娩时具有指导价值,值得推广应用。

Objective To explore and analyze the application values of the head position delivery scoring method in the delivery process of 4 000 pregnant women．Methods Selected 4 000 cases of pregnant women as the study object,all pregnant women gave head delivery score,observed and recorded the delivery mode and head delivery scoring method,recorded the Apgar score of 1 min and 5 min,and recorded the occurrence of postpartum complications of all pregnant women．Results Among the 4 000 pregnant women,156 scored ≤8,894 scored 9-10,and 2 950 scored ≥11．There was no significant difference in the age,gestational age,pregnancy time and delivery status of pregnant women in different head delivery scoring methods（P>0.05）．The cesarean section of patients with ≤8 score was 100.0%,those with 9-10 score and those with ≥11 score were 35.3% and 5.7%,respectively,and there were significant differences（P<0.05）．There was no significant difference in Apgar score between newborns with ≤8 scores,9-10 scores and ≥11 scores at 1 min and 5 min after birth（P>0.05）．The incidence rates of puerperal fever,postpartum hemorrhage,postpartum hematoma and postpartum urinary retention were 13.5%,2.0% and 0.2% in patients with ≤8 score,9~10 score and ≥11 score,respectively,and there were significant differences（P<0.05）．Conclusions The head delivery scoring method has guiding value in handling head delivery in obstetrics and is worth promoting and applying．

目的 探讨唐氏综合征血清学筛查风险值异常孕妇选择接受无创产前基因检测（NIPT）的影响因素,为临床制定对应策略提供参考依据。方法 选取2022年1月—2022年12月唐氏综合征血清学筛查风险值异常孕妇229例,根据是否接受NIPT分为接受组（195例）与不接受组（34例）。收集两组临床资料,采用Lasso-Logistic回归分析唐氏综合征血清学筛查风险值异常孕妇接受NIPT的影响因素。结果 单因素分析显示,年龄、文化水平、居住地、家庭平均月收入、孕前优生优育检查、孕前合并生殖相关疾病、受孕方式、不良孕产史、家族史、补充叶酸、配偶意愿、NIPT认知水平、血清学风险等级是血清学筛查异常孕妇接受NIPT的影响因素（P<0.05）;Lasso回归分析筛选出7个变量,分别为年龄、文化水平、家庭平均月收入、不良孕产史、家族史、NIPT认知水平、血清学风险等级;Logistic回归分析,年龄（OR=6.269,95%CI：2.413~16.285）、文化水平（OR=4.119,95%CI：1.627~10.430）、家庭平均月收入（OR=5.102,95%CI：2.067~12.594）、不良孕产史（OR=5.247,95%CI：1.833~15.021）、家族史（OR=7.416,95%CI：2.952~18.629）、NIPT认知水平（OR=5.751,95%CI：2.338~14.146）、血清学风险等级（OR=7.866,95%CI：3.057~20.238）是血清学筛查异常孕妇接受NIPT的影响因素（P<0.05）。结论 唐氏综合征血清学筛查风险值异常孕妇选择接受NIPT的影响因素较多,包括年龄、文化水平、家庭平均月收入、不良孕产史、家族史、NIPT认知水平、血清学风险等级,能为临床提高NIPT接受度提供指导信息。

Objective To explore the influencing factors of noninvasive prenatal testing（NIPT）for pregnant women with abnormal risk value of serological screening for Down syndrome,and to provide reference for clinical development of corresponding strategies．Methods A total of 229 pregnant women with abnormal serological screening risk values for Down syndrome from January 2022 to December 2022 were selected and divided into acceptance group（195 cases）and non-acceptance group（34 cases）according to whether they received NIPT．The clinical data of the two groups were collected and Lasso-Logistic regression was used to analyze the factors influencing the acceptance of NIPT in pregnant women with abnormal serological screening risk value for Down syndrome．Results In single factor analysis,age,education level,place of residence,average monthly family income,pre-pregnancy and childbearing examination,pre-pregnancy combined with reproductive diseases,conception method,adverse pregnancy history,family history,folic acid supplementation,spouse intention,NIPT cognition level and serological risk grade were the influencing factors for the acceptance of NIPT in pregnant women with abnormal serological screening（P<0.05）．Seven variables were selected by Lasso regression analysis,which were age,education level,average monthly family income,adverse pregnancy history,family history,NIPT cognition level and serological risk level．Logistic regression analysis showed that age（OR=6.269,95%CI：2.413-16.285）,education level（OR=4.119,95%CI：1.627-10.430）,average monthly family income（OR=5.102,95%CI：2.067-12.594）,adverse pregnancy history（OR=5.247,95%CI：1.833-15.021）,family history（OR=7.416,95%CI：2.952-18.629）,NIPT cognitive level（OR=5.751,95%CI：2.338-14.146）and serological risk level（OR=7.866,95%CI：3.057-20.238）were independent influencing factors for NIPT acceptance in pregnant women with abnormal serological screening（P<0.05）．Conclusions There are many influencing factors for pregnant women with abnormal serological screening risk value to accept NIPT,including age,education level,average monthly family income,adverse pregnancy history,family history,NIPT cognition level,serological risk grade,etc．,which can provide guidance information for clinical improvement of NIPT acceptance．

目的 分析宫颈弹性成像(UE)参数在宫颈机能不全(CIC)孕妇妊娠结局中的预测价值。方法 选取我院收治的119例(2019年10月—2021年8月)CIC孕妇,根据妊娠结局分为早产组(孕周＜37周)56例、正常组(孕周≥37周)63例,均于孕20～24周接受阴道超声、宫颈UE检查,获取宫颈长度(CL)、宫颈UE参数[超声弹性对比指数(ECI)、宫颈外口弹性应变率(EOS)、宫颈内口弹性应变率(IOS)]并进行比较,以了解宫颈UE参数在CIC孕妇妊娠结局中的应用价值。结果 早产组CL水平较正常组低,ECI、IOS、EOS水平较正常组高(P＜0.05);单因素分析发现,CL、ECI、IOS、EOS均可对CIC孕妇妊娠结局产生影响(P＜0.05);受试者工作特征(ROC)曲线结果显示,CL、ECI、EOS、IOS预测CIC孕妇早产的AUC分别为0.616、0.765、0.728、0.814,敏感度分别为64.29%、75.00%、73.21%、82.14%,特异度分别为42.86%、52.38%、57.14%、42.86%。结论 宫颈UE参数能有效反映宫颈组织情况,对CIC孕妇妊娠结局具有一定的预测价值。

目的 比较早产胎膜早破(PPROM)≥34周的肥胖孕妇与非肥胖孕妇的早产儿住院结局。方法 回顾性分析2016年1月—2020年12月在本院出生并入住新生儿科的所有出生胎龄≥34周的PPROM早产儿。根据孕妇分娩时体质量指数(BMI),分为肥胖组(BMI≥30 kg/m²)和非肥胖组(BMI＜30 kg/m²),比较2组间的一般情况、妊娠结局及所生晚期早产儿的住院结局,组间比较采用两独立样本t检验及χ²检验。结果 与非肥胖孕妇相比,肥胖孕妇的晚期早产儿分娩后呼吸道并发症发病率高,主要表现为新生儿呼吸窘迫综合征,辅助通气、吸氧和表面活性物质的使用、败血症、感染性肺炎发病率高,母亲妊娠期糖尿病发病率增高,差异均具有统计学意义(P＜0.05),其余新生儿高胆红素血症、新生儿坏死性小肠结肠炎、脑室内出血、早产儿支气管肺发育不良等并发症比较无统计学意义(P＞0.05)。结论 PPROM≥34周的肥胖孕妇与非肥胖孕妇相比,所生晚期早产儿呼吸道并发症和败血症等不良结局的发生率增加。

Objective To compare the hospitalization outcomes of 34 weeks or over preterm infants with preterm premature rupture of membranes (PPROM) in obese and non-obese pregnant women. Methods A retrospective analysis of PPROM preterm infants born in our hospital and admitted to the neonatology department from January 2016 to December 2020 with a gestational age of 34 weeks or over was carried out. According to the pregnant women's body mass index (BMI) at delivery, they were divided into obese group (BMI≥30 kg/m²) and non-obese group (BMI<30 kg/m²). The general conditions, pregnancy outcomes and late premature infants hospitalization outcomes between the two groups were compared using two independent samples t test and χ² test. Results Compared with non-obese pregnant women, the incidence of respiratory complications after delivery in late preterm infants of obese pregnant women was higher, mainly manifested as high incidence of neonatal respiratory distress syndrome, assisted ventilation, oxygen inhalation and the use of surfactants, sepsis, and pneumonia, also maternal gestational diabetes incidence was increased, and the differences were statistically significant (P<0.05); other complications of neonatal hyperbilirubinemia, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia were not statistically significant (P>0.05). Conclusions Compared with non-obese pregnant women with 34 weeks or over PPROM, obese pregnant women had an increased incidence of adverse outcomes in late preterm infants such as respiratory complications and sepsis.

目的 探讨慢性乙型肝炎病毒（HBV）感染对妊娠期糖尿病（GDM）孕妇的妊娠并发症、孕晚期生殖道B族链球菌（GBS）感染情况以及妊娠结局的影响。方法 选取2020年1月1日—12月31日在广州市妇女儿童医疗中心定期产检、足月、单胎妊娠的GDM孕妇共583例,其中合并HBV感染者（GDM+HBV组）48例,无合并者（GDM组）535例。比较2组的妊娠期并发症、妊娠晚期（妊娠35~37周）生殖道GBS感染情况、妊娠结局以及阴道分娩者的母儿结局。结果 与GDM组患者相比,GDM+HBV组患者出现妊娠期肝内胆汁淤积症、孕晚期生殖道GBS感染者比例较高,孕期出现胎盘早剥者比例较高,阴道分娩过程中出现产时发热、羊水粪染和新生儿入住NICU者比例均较高（均P<0.05）。结论 与无合并慢性HBV感染的GDM患者相比,合并慢性HBV感染的GDM患者在围产期的母儿风险升高。

Objective To investigate the effects of chronic hepatitis B virus（HBV）infection on pregnancy complications,group B streptococcus（GBS）infection in third trimester and pregnancy outcome in pregnant women with gestational diabetes mellitus（GDM）．Methods A retrospective study of 583 pregnant women with GDM,singleton gestation and cephalic presentation delivered at term in Guangzhou Women and Children’s Medical Center was carried out．Including 48 GDM women complicated with chronic HBV infection（GDM+HBV group）and 535 GDM women without HBV infection（GDM group）．Pregnancy complications,GBS infection in third trimester（gestation 35-37 weeks）,pregnancy outcomes,maternal and neonatal outcomes of vaginal delivery were compared between the two groups．Results GDM+HBV group had a higher proportion of intrahepatic cholestasis of pregnancy（ICP）and GBS infection in third trimester than GDM group,and a higher proportion of placental abruption during pregnancy．GDM+HBV group showed a significantly increased proportion in intrapartum fever,meconium-stained amniotic fluid and neonatal intensive care unit admission during vaginal delivery than GDM group（all P<0.05）．Conclusions GDM women with chronic HBV infection are associated with increased maternal and fetal risk during pregnancy and delivery．

目的 探讨妊娠中晚期服用奥司他韦对罹患甲流孕妇症状及母婴结局的影响。方法 选择2018年1月—2019年12月在某三甲医院进行就诊且罹患甲型H1N1的20名孕妇作为研究组对象;同时随机选择同一孕期在该医院产检和分娩,妊娠期间未患甲流H1N1的80名正常孕妇作为对照组对象。在给予口服奥司他韦后,记录研究对组对象流感症状的缓解时间。在妊娠结束后,记录两组研究对象的母婴结局,并进行比较。结果 两组孕妇的年龄≥30岁(65.0% vs 56.3%)、孕周≥32周(60.0% vs 52.5%)、汉族(100.0% vs 95.0%)、中学及以下(40.0% vs 45.0%)、月收入≥3500元(70.0% vs 65.0%)比较,差异均无统计学意义(P＞0.05)。服药时间＜48 h和服药时间≥48h研究对象的发热缓解时间[(2.9±0.3)d vs(3.4±0.4)d]、肌肉和关节酸痛的缓解时间[(3.3±0.4)d vs(3.8±0.5)d]、流涕的缓解时间[(5.6±0.5)d vs(6.8±0.7)d]、咽痛的缓解时间[(2.7±0.3)d vs(3.4±0.5)d]、咳嗽的缓解时间[(8.1±0.6)d vs(9.6±0.8)d]、体力恢复时间[(7.8±0.9)d vs(9.2±0.7)d]比较,服药时间＜48 h者低于服药时间≥48 h者,差异均有统计学意义(P＜0.05)。两组孕妇的自然流产(5.0% vs 2.5%)、死胎(0.0 vs 1.3%)、胎膜早破(10.5% vs 13.8%)、顺产(79.0%vs 81.8%)、低出生体重(15.8%vs 19.5%)比较,差异均无统计学意义(P＞0.05)。结论 奥司他韦对于缓解善中晚期孕妇的甲型H1N1流感症状和预防甲型H1N1带来的不良母婴结局具有良好作用,具有良好的临床推广意义。

目的 探讨四君寿胎汤对地中海贫血孕妇贫血状况的改善效果,以期指导地中海贫血孕妇的中药治疗。方法 选择2019年5月—2020年10月期间我院诊治的200例地中海贫血孕妇,根据随机数字表法将其分为两组,观察组与对照组,各100例,观察组患者给予四君寿胎汤,1剂/d,连续治疗3个月,对照组患者给与安慰剂,1剂/d,连续治疗3个月;治疗前、治疗3个月后,比较两组血液检测指标[血红蛋白(HGB)、红细胞(RBC)、红细胞比容(HCT)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)]、中医症候积分、肝肾指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Cre)、尿素(ure)、总胆汁酸(TBA)],记录两组孕妇妊娠结局、新生儿情况并比较。结果 治疗前,两组HGB、RBC、HCT、MCV、MCH比较,差异无统计学意义(P＞0.05);治疗3个月后,两组均升高,且观察组高于对照组(P＜0.05);治疗前,两组食少纳呆、体倦乏力、食后或午后腹胀、大便异常症候积分比较,差异无统计学意义(P＞0.05);治疗结束后,两组症候积分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗前后,两组ALT、AST、TBA、Cre、Ure差异无统计学意义(P＞0.05)。两组胎儿宫内窘迫、宫内生长受限发生率、产妇产后出血率比较,观察组较对照组发生率低,但差异无统计学意义(P＞0.05)。观察组早产发生率较对照组明显下降,差异有统计学意义(P＜0.05);观察组孕妇分娩孕周大于对照组,剖宫产率低于对照组,差异有统计学意义(P＜0.05);两组新生儿窒息率、转PICU率比较,差异无统计学意义(P＞0.05);观察组新生儿出生体重、HGB高于对照组(P＜0.05)。结论 四君寿胎可以改善地中海贫血孕妇的整体贫血状况,对肝肾功能无不良影响,中医证候得到改善,且有利于减少早产发生风险,降低剖宫产率,改善新生儿情况。

Objective To investigate effect of Sijun Shoutai decoction in improving anemia status of pregnant women with thalassemia, and to guide the Chinese medicine treatment of thalassemia in pregnant women in the future. Methods Two hundred pregnant women with thalassemia who were diagnosed in the hospital from May 2019 to October 2020 were divided into observation group and control group randomly, with 100 cases in each group. The observation group was treated with Sijun Shoutai decoction,1 dose/d, with continuous treatment for 3 months. The control group was given placebo,1 dose/d, with continuous treatment for 3 months. The indicators of blood test [hemoglobin (HGB), red blood cell (RBC), hematocrit value (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH)], TCM symptom scores, hepatic and renal indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cre), urea (Ure), total bile acid (TBA)] were compared between the two groups before and after treatment for 3 months. The maternal pregnancy outcome and neonatal condition in the two groups were recorded and compared. Results There were no statistical difference in the HGB, RBC, HCT, MCV and MCH between the two groups before treatment (P>0.05); after 3 months the indicators above of two groups increased, and those in observation group were higher than those in control group (P<0.05). There were no statistical differences in the symptom scores of poor appetite, fatigue, abdominal distension after eating or after noon and fecal abnormalities between the two groups before treatment (P<0.05). The levels of ALT, AST and TBA in the two groups decreased after treatment for 3 months, while the Cre and Ure increased, but the differences were not statistically significant (P>0.05). There were no statistical differences in the rates of intrauterine fetal distress, intrauterine growth restriction, and postpartum hemorrhage between the two groups (P>0.05), though the results of observation group were lower than control group.The rate of premature birth was lower than that of control group(P<0.05) ; the gestational week of observation group was more than control group, and the cesarean section rate of observation group was lower than that of control group (P<0.05). There were no statistical differences in the rates of neonatal asphyxia and transfering to PICU between the two groups (P>0.05); the neonatal birth weight and HGB in observation group were higher than those in control group (P<0.05). Conclusion Sijun Shoutai decoction in the treatment of pregnant women with thalassemia can improve anemia status, with no adverse effect on liver or kidney function, improve TCM syndrome, reduce the risk of premature birth,reduce the rate of cesarean,and improve the neonatal condition.

目的 分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇接受胰岛素治疗对妊娠结局的影响及安全性。方法 将2018年7月—2020年7月接诊且行常规治疗的50例GDM孕妇作为对照组,将同期接诊且在对照组基础上行胰岛素治疗的50例GDM孕妇作为观察组,对组间血糖控制效果、生活质量(SF-36)、治疗效果、不良妊娠结局、不良反应展开分析。结果 (1)组间血糖指标在治疗前无明显差异(P＞0.05);治疗后,观察组血糖控制效果优于对照组(P<0.05);(2)观察组SF-36评分高于对照组,且治疗效果(96.00%)优于对照组(82.00%,P<0.05);(3)观察组出现3例不良妊娠结局(6.00%),对照组出现11例不良妊娠结局(22.00%,P<0.05);(4)观察组发生3例不良反应(6.00%),对照组发生2例不良反应(4.00%,P＞0.05)。结论 对GDM孕妇实施胰岛素治疗,可以改善孕妇血糖水平,减少不良妊娠结局,提高孕妇生活质量,安全可靠,值得推广。

Objective To analyze the effect and safety of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus (GDM). Methods A total of 50 pregnant women with GDM who received conventional treatment from July 2018 to July 2020 were induded in the control group, and 50 pregnant women with GDM who received insulin treatment on the basis of the control group were induded in the observation group. Results (1) There was no significant difference in blood glucose index between two groups before treatment(P＞ 0.05); after treatment, the blood glucose control effect of the observation group was better than that of the control group(P<0.05); (2) SF-36 score of the observation group was higher than that of the control group, and the treatment effect (96.00%) was better than that of the control group (82.00%,P<0.05); (3) there were 3 cases of adverse pregnancy outcomes (6.00%) in the observation group and 11 cases (22.00%) in the control group; (4) there were 3 cases of adverse reactions (6.00%) in the observation group and 2 cases (4.00%) in the control group(P＞ 0.05). Conclusion Insulin therapy for pregnant women with GDM could improve the blood glucose level of pregnant women, reduced adverse pregnancy outcomes, improved the quality of life of pregnant women, which is safe and reliable, and is worthy of promotion.

目的 探讨孕中后期中低等强度有氧运动对高龄孕妇产前生活质量和母婴结局的影响。方法 选2017年8月—2018年12月我院接收的560名高龄孕妇作为研究对象,随机分成数量相等的两组。对照组采取常规孕期保健服务和健康教育,观察组则在此基础上增加孕中后期中低等有氧运动的干预,问卷法调查两组孕妇的抑郁情况、睡眠质量、产前生活质量,并比较两组孕妇的母婴结局。结果 χ²检验结果显示,研究组对象平均每周运动次数≥3次及平均每次运动时间≥30 min的比例高于对照组(P=0.001)。研究组对象的EPDS抑郁分值和SRSS睡眠质量分值均低于对照(P=0.006)。研究组对象产前GQOLI-74生活质量问卷中生活质量总得分高于对照组(P=0.000 1)。研究组对象的妊娠糖尿病、妊娠高血压、难产率、巨大儿发生率均低于对照组(P=0.039),但自然分娩率高于对照组(P=0.004)。结论 以瑜伽、慢走或散步为主的中低强度的有氧运动可能有助于提供高龄孕妇的产前生活质量,预防妊娠疾病和不良母婴结局,在临床上具有一定的推广意义。

Objective To study the influences of medium or low strength aerobics during 2^nd and 3^rd trimester on life quality and pregnant outcome of elderly pregnant women. Methods To select 560 elderly pregnant women in our hospital during August 2017 to December 2018 as the objects of this study. Objects were divided into control group which was given routine pregnant health services and study group which was given medium or low strength aerobicsduring 2^nd and 3^rd trimester excluding in addition. Questionnaires were used for collecting messages of depression, sleeping, life quality of objects. Pregnant outcome were compared of two groups by Chi-square test in this study. Results The ratio of average aerobics more than 3 times per week and average time more than 30min each time of study group were higher than control group(P=0.001). The scores of EPDS and SRSS of study group were lower than control group(P=0.006). The scores of GQOLI-74 of study group were higher than control group(P=0.000 1). The ratio of pregnant diabetes mellitus, pregnant hypertension, dystocia, fetal macrosomia of study group were lower than control group(P=0.039) but the ratio of eutocia was higher than control group(P=0.004). Conclusion The medium or low strength aerobics such as Yoga, taking a walk may improve pregnant life quality of elderly pregnant women and prevent pregnancy disease and abnormal pregnant outcome that deserved to promote in clinic.