目的　评估糖尿病孕妇胎儿心脏筛查策略的成本与效果。 方法　对199例因孕母糖尿病转诊胎儿超声心动 图检查的孕妇进行理论最小成本分析，评估此类孕妇进行常规筛查和胎儿超声心动图筛查的成本与效果。结果　199例糖 尿病孕妇最终筛查出9例先天性心脏病患儿。目前的筛查策略是对所有糖尿病孕妇进行孕中期胎儿畸形筛查和胎儿超声 心动图检查，以及对产前发现先天性心脏病或即使只有良性发现的病例均进行生后超声心动图检查，每产前检出一例先 天性心脏病的费用为13 045.67元；若筛查策略仅对拥有其他转诊因素的糖尿病孕妇进行胎儿超声心动图检查，且仅对有 产前发现先天性心脏病或其他良性发现的病例进行生后超声心动图检查，每产前检出一例先天性心脏病的费用会降低至 8 475.22元。结论　在完成孕中期胎儿畸形筛查后，对伴有其他转诊指征的糖尿病孕妇行选择性的胎儿超声心动图检查， 并对有产前心脏异常的病例选择性进行生后超声心动图检查的心脏筛查策略相比其他筛查策略性价比更高。

　Objective　To assess the cost and effectiveness of the referral efficiency in the fetal cardiac screening of diabetic pregnancies. Method　Theoretical minimized cost analysis was performed in 199 diabetic pregnancies, to evaluate the cost and effectiveness of the screening strategy for these referrals. Results　In pregnancies referred for diabetes mellitus, nine children with congenital heart disease were finally screened out. The current cardiac screening strategy of anatomic survey and fetal echocardiography for all diabetic pregnancies, and postnatal echocardiography only for cases with prenatal detection of congenital heart disease or even benign findings as indicated, would cost 13045.67 CNY for each prenatal detection of congenital heart disease. If fetal echocardiography was performed in diabetic pregnancies with other referral indications and postnatal echocardiography were performed only in cases with prenatal detection of congenital heart disease or other benign findings, the cost of each prenatal detection of congenital heart disease would decrease to 8475.22 CNY. Conclusion　The economic analysis of diabetic pregnancies indicated that, the cardiac screening strategy of selective fetal echocardiography for diabetic pregnancies with other referral indications for fetal echocardiography after fetal anatomic survey and selective postnatal echocardiography only for cases with prenatal cardiac findings, was more cost-effective.