妊娠期糖尿病的影响因素及其对不良妊娠结局的影响

发布时间：2018-06-12 01:37

本文选题：妊娠期糖尿病 + 影响因素　；参考：《暨南大学学报(自然科学与医学版)》2017年03期

【摘要】：目的:探讨孕妇患妊娠期糖尿病(GDM)的影响因素,并分析GDM对不良妊娠结局的影响.方法:选取476例进行产前随诊的孕妇,于孕24~32周进行75 g葡萄糖耐量试验(OGTT),根据血糖检测结果筛查GDM,通过问卷收集信息并随访至分娩,采用多因素Logistic回归分析GDM的影响因素,并比较GDM组(69例)和非GDM组(407例)的不良妊娠结局的差异,分析GDM对不良妊娠结局的影响.结果:孕妇年龄高(OR=1.085,95%CI 1.004~1.173)、居住郊区(OR=1.914,95%CI 1.004~3.650)、孕前体质量指数(BMI)高(OR=1.110,95%CI 1.000~1.231)、糖尿病家族史(OR=3.583,95%CI 1.961~7.588)是GDM的危险因素;GDM组的新生儿高胆红素血症发病率(26.1%)高于非GDM组(6.9%),GDM组的产后出血发病率(37.7%)高于非GDM组(25.6%),均具有统计学差异(P0.05);GDM组的巨大儿出生率、新生儿败血症、胎儿窘迫、剖宫产及胎盘功能不全的发病率均高于非GDM组,但不具有统计学差异(P0.05).结论:GDM对不良妊娠结局存在影响,应对孕妇尤其是高龄、肥胖、有糖尿病家族史的孕妇进行早期筛查,及时干预,避免不良妊娠结局发生;在人群中,尤其是农村地区,普及孕妇合理平衡膳食和健康妊娠的知识.
[Abstract]:Objective: to investigate the influencing factors of gestational diabetes mellitus (GDM) in pregnant women and to analyze the effect of GDM on adverse pregnancy outcomes. Methods: a total of 476 pregnant women with prenatal follow-up were selected and 75 g glucose tolerance test (OGTT) was performed at the second week of gestation. The GDMs were screened according to the blood glucose test results. The information was collected by questionnaire and followed up to labor. The influencing factors of GDM were analyzed by multivariate logistic regression analysis. The difference of adverse pregnancy outcome between 69 cases of GDM group and 407 cases of non-GDM group was compared, and the influence of GDM on adverse pregnancy outcome was analyzed. Results: the risk factors of GDM were 1.91495CI 1.0041.173, 1.91495CI 1.004 3.650, BMI1.11095 CI 1.231.The family history of diabetes OR3.583959595 CI 1.9617.588) was the risk factor of GDM. The incidence of neonatal hyperbilirubinemia in GDM group was higher than that in non-GDM group (6.995% CI 1.231C = 26.11). The incidence of neonatal hyperbilirubinemia in GDM group was higher than that in non-GDM group (6.990%), and the incidence of neonatal hyperbilirubinemia in GDM group was higher than that in non-GDM group (6.995% CI 1.231a). The incidence of neonatal hyperbilirubinemia in GDM group was higher than that in non-GDM group. The incidence of macrosomia in GDM group was significantly higher than that in non-GDM group (P 0.05). The incidence of neonatal septicemia, fetal distress, cesarean section and placental dysfunction was higher than that of non-GDM group, but there was no statistical difference (P 0.05). Conclusion there is an influence on the adverse pregnancy outcome by the weight GDM. The pregnant women, especially those who are old, obese and have a family history of diabetes mellitus, should be screened early, intervention should be made in time to avoid the adverse pregnancy outcome, especially in the rural areas. To popularize the knowledge of reasonable balanced diet and healthy pregnancy for pregnant women.
【作者单位】：暨南大学附属第一医院临床营养科;暨南大学附属第一医院妇产科;
【基金】：广州市科技计划项目(201510010213)
【分类号】：R714.256

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