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(P<0.05);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(P>0.05).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.
Aim: To explore the influence factors of pregnant women with gestational diabetes mellitus(GDM),and analyze its effects on adverse pregnancy outcomes. Methods: The data were collected through questionaires. The 75 g oral glucose tolerance test(OGTT) was used to screen for GDM patients between 24 and 32 gestational weeks,and all the pregnancy were followed up to delivery. And the multivariate logistic regression was used to analyze the influence factors of GDM. And the effects of GDM on adverse pregnancy outcomes were also analyzed through comparing the differences in adverse pregnancy outcomes between GDM group and non-GDM group. Results: The result of multivariate unconditional logistic regression showed that the elderly(OR = 1. 085,95% CI 1. 004 ~ 1. 173),living in suburb(OR = 1. 914,95% CI 1. 004 ~ 3. 650),high BMI before pregnancy(OR = 1. 110,95% CI 1. 000~ 1. 231),and family history of diabetes(OR = 3. 583,95% CI 1. 961 ~ 7. 588) were risk factors forGDM. The neonate hyperbilirubinemia in GDM group(26. 1%) was higher than in non-GDM group(6. 9%),and the incidence of postpartum hemorrhage in GDM group(37. 7%) was also higher than in non-GDM group(25. 6%)(P < 0. 05 in both). In addition,the incidences of fetal macrosomia,neonatal sepsis,fetal distresses,cesarean section and placenta insufficiency in GDM group were all higher than in non-GDM group respectively, though neither of them was of statistically significant difference(P > 0. 05 in all). Conclusion: GDM has significant impact on adverse pregnancy outcomes.In order to avoid adverse pregnancy outcomes,more attention should be paid to the early screening for pregnant women,especially the elderly,obese ones with family history of diabetes. What 's more,dietary guidelines and health education on gestation should be provided among all the populations,especially the rural residents.
出处
《暨南大学学报（自然科学与医学版）》
CAS
CSCD
北大核心
2017年第3期264-268,共5页
Journal of Jinan University(Natural Science & Medicine Edition)
基金
广州市科技计划项目(201510010213)
关键词
妊娠期糖尿病
影响因素
不良妊娠结局
gestational diabetes mellitus(GDM)
influence factors
adverse pregnancy outcomes
