2015-2016年厦门市再生育孕妇妊娠期糖尿病发病危险因素

发布时间：2018-06-09 23:52

  本文选题：再生育 + 妊娠期糖尿病　； 参考：《卫生研究》2017年06期

【摘要】：目的探讨再生育孕妇妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的相关危险因素。方法于2015—2016年在厦门市妇幼保健院围产营养门诊,按照孕期保健手册的建卡编号随机选择393例GDM患者,并以年龄段为匹配因素进行1∶1配对,以393例糖耐量试验正常的孕妇作为对照组。收集妊娠前体质指数、文化程度、流产次数、产检时的孕周及体重、父母亲患糖尿病史、上一胎胎儿出生体重、有无妊娠期糖尿病史等资料,两组人群均为再生育孕妇。结果 (1)单因素分析显示:GDM组孕妇孕24周前体重增长高于对照组[(9.11±3.09)kg vs(7.54±2.95)kg,t=2.121,P=0.004],母亲患糖尿病的比例高于对照组(64/393 vs 38/393,χ~2=7.616,P=0.006),而对照组文化程度总体水平高于GDM组(Z=-4.060,P=0.001)。配对卡方分析显示,巨大儿分娩史(χ~2=14.297,P=0.001)、妊娠期糖尿病史(χ~2=12.938,P=0.001)及流产次数≥2次(χ~2=7.078,P=0.010)均是再生育孕妇发生GDM的危险因素。随着上一胎胎儿出生体重的增长,下一孕期GDM发病的风险也逐渐增加。当出生体重达到3.8 kg时,OR=3.467,该风险值达到强相关程度。(2)多因素Logistic回归分析显示:单因素分析中,差异有统计学意义的危险因子均是GDM发病的高危因素,其中孕24周前体重增长超过10 kg的影响最大(OR=1.875,P=0.001)。结论妊娠期糖尿病史、巨大儿分娩史、流产次数≥2次、妊娠24周前体重总增长超过10 kg、文化程度水平相对低、孕妇母亲患糖尿病史均是GDM发病的危险因素;对于上一胎胎儿出生体重达到3.8 kg以上的再生育孕妇,应被纳入GDM发病的高危人群。
[Abstract]:Objective to investigate the risk factors associated with gestational diabetes mellitusus (GDM) in pregnant women with gestational diabetes mellitus (GDM). Methods 393 patients with GDM were randomly selected in the perinatal nutrition clinic of Xiamen Maternal and Child Health Hospital from 2015 to 2016. 393 patients with GDM were randomly selected according to the establishment card number of the health care manual during pregnancy. 393 pregnant women with normal glucose tolerance test were used as control group. The data of body mass index (BMI) before pregnancy, education level, abortion frequency, gestational weeks and body weight during birth examination, parents history of diabetes mellitus, birth weight of the last fetus, history of gestational diabetes mellitus and so on were collected. The two groups were all pregnant women. Results (1) univariate analysis showed that the weight gain before 24 weeks of gestation was higher in the w GDM group than that in the control group [9.11 卤2.95 3.09)kg vs(7.54 卤2.121kg. P0. 004], and the incidence of diabetes in the mother was higher than that in the control group (64 / 393 vs 38 / 393, 蠂 ~ (2 +) 7.616P0. 006), while the overall educational level in the control group was higher than that in the GDM group. Matched chi-square analysis showed that the history of macrosomia delivery (蠂 2 / 14.297), history of gestational diabetes mellitus (蠂 ~ 2 / 2 = 12.938 / P ~ 0.001) and the number of miscarriages 鈮，

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