黄岛区妊娠期糖尿病患病率调查及相关危险因素研究

发布时间：2018-07-27 14:38

【摘要】：目的:本研究主要探讨二胎政策后黄岛区孕妇妊娠期糖尿病的患病率及相关危险因素。方法:采用整群随机抽样的方法分别抽取青岛大学附属医院黄岛院区、开发区人民医院和黄岛区中医院,于2016年1月1日至7月31日对在青岛市黄岛区建立孕产妇保健手册在以上三家医院接受75g-2h口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)的单胎妊娠孕妇进行调查研究,收集临床实验检查资料。经过计算样本量至少需要4681,本次共调查4959名孕妇。对妊娠期糖尿病(gestational diabetes mellitus,GDM)的筛查采用国际糖尿病协会与妊娠研究组织(International Association of Diabetes and Pregnancy Study Group,IADPSG)新的诊断标准即空腹血糖≥5.10mmol/L或者1小时血糖≥10.00 mmol/L或者2小时血糖≥8.50 mmol/L,只要一项超过界值就可以诊断为GDM。定量资料组间比较采用t检验,定性资料组间比较采用χ2检验。应用Logistic回归分析调查相关危险因素,其中GDM是因变量,相关风险因素被认为是自变量。Logistic回归分析优势比(OR)和95%置信区间(CI)对GDM的危险因素进行单因素和多因素分析。p0.05为差异有统计学意义。结果:1.全区共调查孕妇4959人,数据显示年龄25岁组为402人,25~29岁组为2436人,30~34岁组为1422人,≥35岁组为699人,其中25~29岁组所占比例最大为49.1%,其次是30~34岁组为28.7%。2.孕妇文化程度主要集中在本科和专科,分别占38.4%和33.2%。两组之和高达71.6%。3.家庭月总收入分布情况看,5000-6999元和7000-9999元所占比例最大,分别是27.7%和33.4%。4.孕妇中孕次为1的比例占49.80%,其次是孕次为2的占33.8%,孕次≥3的是16.30%,一胎孕妇占到65%,二胎及以上的孕妇占到35%。5.根据IADPSG诊断标准GDM患病率为21.8%(1080/4959),其中non-GDM和GDM组的平均孕周分别为(35.65±2.67)和(35.33±2.62),孕周在两组之间没有差异(p=0.706)。孕妇的平均年龄GDM组高于non-GDM组(32.01±4.32和29.23±3.56岁,p0.001)。孕期体重增长和孕前身体质量指数(Body Mass Index,BMI),GDM组高于non-GDM组。与糖耐量正常的孕妇相比,GDM的孕妇学历较低、孕次≥1、多产次和父母糖尿病史,且p0.05,差异有统计学意义。此外,孕早期血红蛋白平均水平GDM组高于non-GDM组(123.66±8.23vs.121.01±7.97 g/L,p=0.003)。6.多因素逻辑回归分析显示:孕妇的年龄30~34岁组(OR=2.288,95%CI=1.163-4.499,p=0.016),年龄≥35岁组(OR=4.878,95%[CI]=2.379-10.000,p0.001),孕前体重指数(BMI)超重(OR=2.441,95%CI=1.782-3.344)或肥胖(OR=10.846,95%CI=6.003-19.597,p0.001),父亲的糖尿病史(OR=2.543,95%CI=1.383-4.674,p=0.003)和母亲糖尿病史(OR=3.598,95%CI=2.163-5.984,p0.001)。结论:此次调查发现二胎政策后黄岛区GDM的患病率高达21.8%。GDM的独立危险因素有高龄孕妇、孕前BMI超重/肥胖和一级亲属的糖尿病家族病史。我们发现GDM发生风险从30岁以后随着母亲年龄的递增而显著增高。母系糖尿病的遗传倾向相比父系糖尿病与GDM发病更加密切。
[Abstract]:Objective: to investigate the prevalence and risk factors of gestational diabetes mellitus (GDM) in pregnant women in Huangdao District after the second trimester policy. Methods: cluster random sampling was used to select the Huangdao Hospital, the people's Hospital of the Development Zone and the Chinese Medicine Hospital of the Huangdao District, Qingdao University. From January 1 to July 31, 2016, the pregnant women with single pregnancy who received 75g-2h oral glucose tolerance test (oral glucose tolerance testOGTT) in three hospitals in Huangdao District of Qingdao were investigated and the data of clinical test were collected. A total of 4959 pregnant women were surveyed at least 4681 after calculating the sample size. The screening of gestational diabetes mellitus (gestational diabetes mellitusus) using the new diagnostic criteria of the International Diabetes Association and the pregnancy Research Organization (International Association of Diabetes and Pregnancy Study Group IADPSG: fasting blood glucose 鈮，

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