Abstract: To compare the demographic characteristics，antenatal care and perinatal outcomes in pregnant women with different blood glucose levels in Kunming，so as to guide pre-pregnant preparation and antenatal care，reduce the occurrence of maternal and infant adverse events，and improve maternal and infant outcomes.Methods　From 2005 to 2013，21 767 pregnant women who underwent regular antenatal care and delivered a single baby in First Affiliated Hospital of Kunming Medical University，were enrolled and divided into three groups according to their blood glucose status：normal glucose tolerance （NGT），gestational diabetes mellitus （GDM） and pre-gestational diabetes mellitus （PGDM）.Demographic characteristics，antenatal care，general neonatal conditions and perinatal outcomes were compared between the three groups.Results　（1） NGT group had the lowest mean age.GDM group had lower mean height and higher mean pre-pregnancy BMI，BMI at the OGTT，and BMI immediately prior to delivery compared with NGT group.PGDM group had higher mean pre-pregnancy BMI，BMI at the OGTT，and BMI immediately prior to delivery and shorter mean years of schooling compared with other two groups（P<0.05）.The prevalence rates of ≥35 years old，pre-pregnancy BMI ≥25 kg/m2 and family history of DM in GDM group were higher than those of NGT group（P<0.016 7）．PGDM group had higher prevalence rates of ≥35 years old，BMI≥25 kg/m2，family history of DM and years of schooling ≤12 than other two groups（P<0.016 7）．（2） The gestational weight gain and gestational age of GDM group were less than those of NGT group （P<0.05）.The gestational weight gain，times of receiving antenatal care and gestational age of PGDM group were less than those of other two groups （P<0.05）.The proportion of pregnant women transferred from other hospitals to First Affiliated Hospital of Kunming Medical University was lower in NGT group compared with other two groups （P<0.016 7）．（3） GDM group had less neonatal birth weight and height than NGT group （P<0.05），as PGDM group did when compared with GDM and NGT groups （P<0.05）．（4） PGDM group showed higher incidence rates of maternal preeclampsia and pregnancy-induced hypertension，premature delivery，receiving neonatal ICU care，neonatal hypoglycemia，receiving neonatal blue light phototherapy （NBLP） due to newborn jaundice than both NGT and GDM groups，as did GDM group when compared with NGT group（P<0.016 7）.Moreover，NGT group showed lower incidence rates of large for gestational age，macrosomia and perinatal death than GDM group，and lower incidence rates of cesarean section and large for gestational age than PGDM group （P<0.016 7）.Conclusion The incidence rates of adverse maternal and infant events in PGDM group were higher than in NGT and GDM groups，even with standardized management.Therefore，the importance of pre-pregnancy care and early identification of PGDM should be emphasized.

Key words: Diabetes mellitus, Previous gestational diabetes mellitus, Gestational diabetes mellitus, Demographic characteristics, Pregnancy complications, Maternal-fetal outcomes

摘要： 目的　比较昆明市不同血糖情况孕妇的人口统计学特征、孕期保健及围生期结局，以期指导孕妇孕前准备及孕期保健，降低母婴不良事件的发生，改善母婴结局。方法　收集2005—2013年于昆明医科大学第一附属医院定期产检至分娩单胎的21 767例孕妇为研究对象，分为正常糖耐量（NGT）组、妊娠期糖尿病（GDM）组及孕前糖尿病（PGDM）组3组。比较3组人口统计学特征、孕期保健情况、新生儿一般情况及围生期结局。结果　GDM和FGDM组平均年龄高于NGT组，GDM组平均身高低于NGT组，GDM组孕前/OGTT时/分娩前BMI高于NGT组，FGDM组孕前/OGTT时/分娩前BMI高于NGT和GDM组、受教育年限低于NGT和GDM组（P<0.05）；GDM组年龄≥35岁、孕前BMI≥25 kg/m2、有DM家族史者占比高于NGT组，FGDM组孕前年龄≥35岁、BMI≥25 kg/m2、有DM家族史、受教育年限≤12年者占比高于NGT和GDM组（P<0.016 7）。GDM组孕期增重、分娩孕周小于NGT组，PGDM组孕期增重、产检次数、分娩孕周小于NGT和GDM组（P<0.05）；GDM和PGDM组由外院转入者占比高于NGT组（P<0.016 7）。GDM组出生体质量、身长小于NGT组，PGDM组身长小于NGT和GDM组（P<0.05）。GDM组母亲子痫前期、妊娠高血压疾病、新生儿大于胎龄儿、巨大儿、早产、入住新生儿重症监护病房、低血糖、黄疸需蓝光治疗、围生儿死亡者占比高于NGT组，PGDM组母亲剖宫产、新生儿大于胎龄儿者占比大于NGT组，PGDM组母亲子痫前期、妊娠高血压疾病、新生儿早产、入住新生儿重症病房、低血糖、黄疸需蓝光治疗者占比高于NGT和GDM组（P<0.016 7）。结论　即使给予PGDM组规范的治疗与干预，母婴结局的负面影响仍明显高于NGT和GDM组，因此应强调孕前保健及PGDM早期识别的重要性。

关键词: 糖尿病, 孕前糖尿病, 妊娠期糖尿病, 人口统计学, 妊娠期合并症, 围生期结局