妊娠期糖尿病危险因素分析及对妊娠结局的影响研究
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摘要
目的探讨妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)发生的相关危险因素,并对其妊娠结局进行分析。方法回顾性分析2015年2月—2018年2月在该院分娩的139例产妇的临床资料,依据口服葡萄糖耐糖量试验结果将其划分为GDM组(35例)与非GDM组(104例),分析妊娠期糖尿病危险因素,并对比两组妊娠结局。结果两组HBsAg阳性率、阴道念珠菌感染率对比,差异无统计学意义(P>0.05);GDM组糖尿病家族史、年龄≥35岁、孕次≥3次、孕前BMI≥24 kg/m~2、流产次数≥3次占比均高于非GDM组,差异有统计学意义(P<0.05);经Logistic回归分析发现,糖尿病家族史、年龄≥35岁、孕次≥3次、孕前BMI≥24 kg/m~2、流产次数≥3次均为GDM发生的独立危险因素(OR>1,P<0.05);GDM组早产、胎膜早破、产后出血、羊水过多及妊娠期高血压发生率均高于非GDM组,差异有统计学意义(P<0.05);两组新生儿死亡发生率对比,差异无统计学意义(P>0.05);GDM组胎儿窘迫、巨大儿、新生儿窒息及新生儿畸形发生率均高于非GDM组,差异有统计学意义(P<0.05)。结论糖尿病家族史、年龄≥35岁、孕前BMI≥24 kg/m~2等均为妊娠期糖尿病发生的危险因素,且妊娠期糖尿病产妇妊娠不良结局发生率较高,临床应着重关注该类产妇,并通过孕前宣教、饮食管理等干预方式,以为胎儿宫内发育创造良好环境,同时在优生优育方面具有重要意义。
Objective To investigate the risk factors associated with Gestational Diabetes Mellitus(GDM) and to analyze the pregnancy outcome. Methods The clinical data of 139 women who gave birth in our hospital from February 2015 to February 2018 were retrospectively analyzed. According to the results of oral glucose tolerance test, they were divided into GDM group(35 cases) and non-GDM group(104 cases). To analyze the risk factors of gestational diabetes and compare the pregnancy outcomes of the two groups. Results There was no significant difference in HBsAg positive rate and vaginal candida infection rate between the two groups(P>0.05); family history of diabetes in GDM group, age≥35 years old, pregnancy ≥3 times,pre-pregnancy BMI≥24 kg/m~2, abortion proportion of ≥3 times were higher than that of non-GDM group, the difference was statistically significant(P<0.05). Logistic regression analysis showed that family history of diabetes, age ≥35 years old,≥3 times of pregnancy, BMI≥24 kg/m~2 before pregnancy, the number of abortions ≥ 3 times were independent risk factors for GDM(OR>1, P<0.05); the incidence of premature delivery, premature rupture of membranes, postpartum hemorrhage,polyhydramnios and gestational hypertension were higher in GDM group than in the non-GDM group, the difference was statistically significant(P <0.05). There was no significant difference in the incidence of neonatal death between the two groups(P>0.05). Fetal distress, macrosomia, neonatal asphyxia and neonatal malformation in the GDM group were higher than that in the non-GDM group, and the difference was statistically significant(P<0.05). Conclusion The family history of diabetes, age ≥35 years old, pre-pregnancy BMI≥24 kg/m~2 are risk factors for gestational diabetes mellitus, and the incidence of gestational dysplasia in pregnant women with gestational diabetes is high. The clinical focus should be on this type of maternal and pre-pregnancy education, diet management and other interventions, in order to create a good environment for fetal intrauterine development, and at the same time in the eugenics and prenatal education is of great significance.
Objective To investigate the risk factors associated with Gestational Diabetes Mellitus(GDM) and to analyze the pregnancy outcome. Methods The clinical data of 139 women who gave birth in our hospital from February 2015 to February 2018 were retrospectively analyzed. According to the results of oral glucose tolerance test, they were divided into GDM group(35 cases) and non-GDM group(104 cases). To analyze the risk factors of gestational diabetes and compare the pregnancy outcomes of the two groups. Results There was no significant difference in HBsAg positive rate and vaginal candida infection rate between the two groups(P>0.05); family history of diabetes in GDM group, age≥35 years old, pregnancy ≥3 times,pre-pregnancy BMI≥24 kg/m~2, abortion proportion of ≥3 times were higher than that of non-GDM group, the difference was statistically significant(P<0.05). Logistic regression analysis showed that family history of diabetes, age ≥35 years old,≥3 times of pregnancy, BMI≥24 kg/m~2 before pregnancy, the number of abortions ≥ 3 times were independent risk factors for GDM(OR>1, P<0.05); the incidence of premature delivery, premature rupture of membranes, postpartum hemorrhage,polyhydramnios and gestational hypertension were higher in GDM group than in the non-GDM group, the difference was statistically significant(P <0.05). There was no significant difference in the incidence of neonatal death between the two groups(P>0.05). Fetal distress, macrosomia, neonatal asphyxia and neonatal malformation in the GDM group were higher than that in the non-GDM group, and the difference was statistically significant(P<0.05). Conclusion The family history of diabetes, age ≥35 years old, pre-pregnancy BMI≥24 kg/m~2 are risk factors for gestational diabetes mellitus, and the incidence of gestational dysplasia in pregnant women with gestational diabetes is high. The clinical focus should be on this type of maternal and pre-pregnancy education, diet management and other interventions, in order to create a good environment for fetal intrauterine development, and at the same time in the eugenics and prenatal education is of great significance.
引文
[1]许佳章,张红敏,于微,等.深圳地区初产妇妊娠期糖尿病发病现状及危险因素分析[J].中国热带医学,2017,17(12):1214-1217,1239.
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[5]范岩峰,许榕仙,蔡丽丽,等.2015-2016年厦门市再生育孕妇妊娠期糖尿病发病危险因素[J].卫生研究,2017,46(6):925-929.
[6]黄雅铃,杨晓波,龙禹,等.广西地区妊娠期糖尿病的危险因素分析及其风险预测模型的建立[J].广西医科大学学报,2017,34(6):835-838.
[7]虞国芬,杜易.妊娠期糖尿病患病危险因素及其对妊娠结局的影响[J].中国妇幼保健,2017,32(17):4070-4072.
[8]袁妙兰,李意,冯慧芳,等.妊娠期糖尿病危险因素研究及对妊娠结局的影响[J].中国医师杂志,2017,19(10):1538-1541.
[2]Hiersch L,Berger H,Okby R,et al.Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies[J].Archives of Gynecology&Obstetrics,2018,298(3):579-587.
[3]Adam S,Rheeder P.Screening for gestational diabetes mellitus in a South African population:prevalence,comparison of diagnostic criteria and the role of risk factors[J].South African medical journal=Suid-Afrikaanse tydskrif vir geneeskunde,2017,107(6):523.
[4]刘眉,王兴和,张铭承,等.妊娠期糖尿病的复发率、复发的危险因素及复发性妊娠期糖尿病母婴预后的分析[J].医学临床研究,2018,35(5):845-848.
[5]范岩峰,许榕仙,蔡丽丽,等.2015-2016年厦门市再生育孕妇妊娠期糖尿病发病危险因素[J].卫生研究,2017,46(6):925-929.
[6]黄雅铃,杨晓波,龙禹,等.广西地区妊娠期糖尿病的危险因素分析及其风险预测模型的建立[J].广西医科大学学报,2017,34(6):835-838.
[7]虞国芬,杜易.妊娠期糖尿病患病危险因素及其对妊娠结局的影响[J].中国妇幼保健,2017,32(17):4070-4072.
[8]袁妙兰,李意,冯慧芳,等.妊娠期糖尿病危险因素研究及对妊娠结局的影响[J].中国医师杂志,2017,19(10):1538-1541.
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