益生菌联合二甲双胍对妊娠期糖尿病患者血糖、阴道微生态和母胎结局的影响OA

Objective:To investigate the effect of probiotics with metformin combined on blood glucose,vaginal microecology and maternal and fetal outcomes in patients with gestational diabetes mellitus(GDM).Methods:A prospective study was conducted on 260 patients with GDM admitted to our hospital from January 2023 to December 2024.Using the random number table method,the patients were divided into two groups:the metformin group(receiving metformin treatment,n=130,of whom 3 withdrew and 127 were finally included)and the combination group(receiving metformin plus probiotics,n=130,of whom 5 withdrew and 125 were finally included).Glycemic control,vaginal microecology,and maternal and fetal outcomes were compared between the two groups.Results:After intervention,fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and hemoglobin A1c(HbA1c)in both groups were significantly reduced compared to before intervention,and the reduction in the combination group was more significant than that in the metformin group(P<0.05).The ideal blood glucose control rate(96.00%),proportion of vaginal microbiota density grade Ⅱ/Ⅲ(88.00%),proportion of diversity grade Ⅱ/Ⅲ(87.20%),and normal vaginal microecology rate(84.80%)in the combination group were significantly higher than those in the metformin group(85.04%,70.08%,71.65%vs 63.78%,P<0.05);the cesarean section rate(31.20%),overall incidence of maternal complication(11.20%),and overall incidence of adverse perinatal outcomes(17.60%)were significantly lower(44.88%,26.77%vs 39.37%,P<0.05).Conclusion:Probiotics with metformin combined can significantly improve blood glucose control in GDM patients,regulate vaginal microecology,reduce cesarean section rates,and decrease the risk of maternal complications and adverse perinatal outcomes.