妊娠期糖尿病的影响因素及围生结局的研究分析

2015-10-13高雯李卫芹吕凤君冷俊宏

国际妇产科学杂志 2015年4期

高雯，李卫芹，吕凤君，冷俊宏

高雯，李卫芹，吕凤君，冷俊宏

目的：通过对天津地区妊娠期糖尿病（GDM）的影响因素及围生结局进行回顾性分析，加深对GDM的认识，为其防治提供一定的研究依据。方法：选取2014年1—6月参加天津市GDM检测的孕妇47 118例，其中确诊GDM 3 650例纳入GDM组，其余43 468例纳入非GDM组，对两组孕妇的相关资料进行比较分析。结果：GDM组年龄≥35岁、大专及以上学历、孕前超重和肥胖比例均高于对照组，差异有统计学意义（P＜0.01）；多因素Logistic回归分析显示，年龄大、城市户籍、文化程度高、孕前BMI高及多胎妊娠是GDM的危险因素。GDM组剖宫产、早产、妊娠期高血压疾病、巨大儿及低出生体质量儿的发生均高于非GDM组，差异有统计学意义（P＜0.01）。结论：GDM发病与多种因素有关，应重视相关的危险因素，并加强GDM妊娠期管理，降低母婴并发症的发生。

妊娠期糖尿病；影响因素；妊娠结局；并发症

【Abstract】Objective:We retrospectively analyze the potential risk factors and perinatal outcomes of the pregnant women with gestational diabetes mellitus（GDM），in order to provide evidence for prevention and treatment.Methods:Totally there were 47 118 pregnant women who accepted diabetes detection during pregnancy in Tianjin region from January 2014 to June 2014，including 3 650 women with gestational diabetes mellitus（GDM group）and 43 468 women without GDM（non-GDM group）. Related variables of the two groups were compared by using statistical methods.Results:Significant difference was found between GDM group and non-GDM group in age，education，and pre-pregnant overweight/obesity status（P＜0.01）.Logistic regression analysis showed that old age，city registration，high education，large pre-pregnancy BMI and multiple gestations were risk factors for GDM.Women with GDM have significantly high incidence of cesarean delivery，premature delivery，pregnancyinduced hypertension，macrosomia，low birth weight than women with non-GDM（P＜0.01）.Conclusions:Varieties of factors would affect the incidence of GDM.More attention should be paid on risk factors.Strengthening management of pregnant women with GDM will reduce the incidence of maternal and neonatal complications.

【Keywords】Gestational diabetes；Risk factors；Pregnancy outcome；Complication

（J Int Obstet Gynecol，2015，42：381-383）

妊娠期糖尿病（gestational diabetes mellitus，GDM）是指妊娠期发生或首次发现的糖尿病，表现为孕妇妊娠期间出现高血糖现象［1］。GDM发生率世界各国报道1%～14%，我国为1%～5%，近年有明显增高趋势［2］。GDM的致病因素比较复杂，有研究表明，年龄、体质量指数（BMI）、受教育程度及糖尿病家族史等是GDM的经典危险因素［3］。GDM常发生严重的并发症，可导致妊娠期高血压疾病、剖宫产、早产、巨大儿、胎儿生长受限等［4］，威胁母婴健康。本研究对GDM的影响因素及围生结局进行回顾性分析，以加深对GDM的认识，为GDM的防治提供一定依据。