妊娠期糖尿病患者发病及不良妊娠结局的影响因素分析

发布时间：2018-09-18 14:09

【摘要】：目的本研究通过病例对照研究,探讨妊娠期糖尿病(GDM)发病的影响因素,分析GDM发生不良结局的影响因素,以期为更好地防治GDM的发生、提高母婴健康水平提供依据。方法本资料来源于2013年1月~2015年3月于华北理工大学附属医院妇产科门诊产前保健并住院分娩的诊断为GDM的孕产妇168例,合并再入院重复病例6例,剔除未在我院治疗并住院分娩无妊娠结局指标5例、病历资料不完全7例,最终纳入本研究的GDM组150例,同期150例糖耐量正常孕产妇为正常组。为了研究GDM发生不良妊娠结局的影响因素,将GDM组分为不良妊娠结局组和未发生不良结局组。孕妇的一般信息、临床资料和妊娠结局通过填写调查问卷和采集住院病案信息的方式进行录入分析,所有数据采用SPSS 20.0软件进行统计学分析。单因素分析中,两组年龄、孕产次、体重指标等计量资料采用独立样本t检验,用x±s表示。职业、居住地、糖尿病家族史等计数资料采用χ2检验,用百分率表示。多因素分析采用多因素非条件logistic回归分析。结果1 GDM组与正常组对比,单因素分析中年龄、孕前BMI、文化程度、糖尿病家族史和不良孕产史等比较,差异有统计学意义(P0.05);多因素logistic回归分析中年龄[OR=3.137,95%CI(1.103,8.920)]、孕前BMI[OR=3.100,95%CI(1.701,5.651)]、糖尿病家族史[OR=2.524,95%CI(1.091,5.838)]和不良孕产史[OR=3.468,95%CI(1.196,10.058)]的结果有统计学意义(P0.05)。GDM组子痫前期、剖宫产和巨大儿的发生率高于对照组,差异有统计学意义(P0.05)。2发生不良结局组与未发生不良结局组对比,单因素分析中孕前BMI、确诊时BMI、OGTT空腹血糖、FINS和HOMA-IR等比较,差异有统计学意义(P0.05),多因素logistic回归分析中孕前BMI[OR=1.500,95%CI(1.132,1.988)]和OGTT空腹血糖[OR=2.078,95%CI(1.020,4.233)]的结果有统计学意义(P0.05)。结论1年龄≥35岁、孕前BMI≥24.0kg/m2、有糖尿病家族史和不良孕产史是GDM发病的危险因素,具有以上因素的孕妇发生GDM的风险升高。2 GDM孕妇发生子痫前期和巨大儿的风险显著高于正常孕妇,并且剖宫产手术率也明显升高。3 GDM孕妇的75g OGTT空腹血糖升高和孕前BMI增加是GDM孕妇发生不良妊娠结局的危险因素。
[Abstract]:Objective to investigate the influencing factors of (GDM) in gestational diabetes mellitus (GDM) by case-control study, and to analyze the influencing factors of adverse outcome of GDM in order to provide evidence for better prevention and treatment of GDM and improvement of maternal and child health. Methods from January 2013 to March 2015, 168 pregnant and parturient women who were diagnosed as GDM in the outpatient department of obstetrics and gynecology of affiliated Hospital of North China University of Science and Technology were diagnosed as GDM, and 6 cases were re-admitted. Five cases without pregnancy outcome index and 7 cases with incomplete medical records were excluded. 150 cases of GDM group were included in this study, and 150 cases of normal pregnant women with normal glucose tolerance in the same period were included in this study. In order to study the influencing factors of adverse pregnancy outcome in GDM, the GDM group was divided into bad pregnancy outcome group and no adverse pregnancy outcome group. The general information, clinical data and pregnancy outcome of pregnant women were recorded and analyzed by filling out questionnaires and collecting the information of medical records in hospital. All the data were analyzed statistically by SPSS 20.0 software. In univariate analysis, two groups of measurement data, such as age, pregnancy, weight index, were measured by independent sample t test, expressed by x 卤s. The data of occupation, residence and family history of diabetes were measured by 蠂 2 test and expressed as percentage. Multivariate logistic regression analysis was used. Results 1Comparison between GDM group and normal group, age, pre-pregnancy BMI, education, diabetic family history and bad pregnancy history were compared in univariate analysis. There were significant differences in age [OR=3.137,95%CI (1.103 卤8.920)], BMI before pregnancy [OR=3.100,95%CI (1.701 卤5.651)], family history of diabetes [OR=2.524,95%CI (1.091 卤5.838)] and adverse maternal history [OR=3.468,95%CI (1.196 10.058)] in multivariate logistic regression analysis (P0.05). The incidence of cesarean section and macrosomia was significantly higher in GDM group than in control group (P0.05). The difference was statistically significant (P0.05). 2 there were significant differences between the group with bad outcome and the group with no adverse outcome. In univariate analysis, the fasting blood glucose levels of BMI,OGTT, fins and HOMA-IR were compared during the diagnosis of BMI, before pregnancy. The difference was statistically significant (P0.05). The results of BMI [OR=1.500,95%CI (1.132 卤1.988)] before pregnancy and fasting blood glucose (OR=2.078,95%CI (1.020 卤4.233) in multivariate logistic regression analysis were statistically significant (P0.05). Conclusion 1Age 鈮，

本文编号：2248157