产前抑郁与妊娠期糖尿病相关性队列研究  

Correlation between antenatal depression symptoms and gestational diabetes: a prospective cohort study

作　　者：董青青 何伟健[1] 缪华章[2] 赵庆国 DONG Qing-qing;HE Wei-jian;MIAO Hua-zhang(Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China)

机构地区：[1]广东省妇幼保健院妇女保健科,广州511400 [2]广东省妇幼保健院保健科 [3]广东省计划生育科学技术研究所

出　　处：《中国公共卫生》2019年第1期107-110,共4页Chinese Journal of Public Health

摘　　要：目的探讨产前抑郁症状与妊娠期糖尿病(GDM)的关系,研究抑郁症状能否作为GDM预防的风险因素。方法将2016年1—9月在广东省妇幼保健院产科首次产检并接受抑郁症状评估的1 554名孕妇(孕20周前)纳入调查,追踪随访到24～28周行糖耐量试验(OGTT),根据其结果及医生诊断为GDM,比较有、无抑郁症状组孕妇GDM的发病率,logistic回归分析产前抑郁症状与GDM发病的相关性,并分析影响GDM发病的风险因素。结果 GDM发病率为17.7%,抑郁症状组孕妇GDM发病率(18.5%)高于非抑郁组(17.3%),但2组发病率差异无统计学意义(χ~2=0.3,P=0.57)。logistic回归分析发现产前抑郁与GDM发病无关(OR=1.1,95% CI=0.82～1.43),高龄(OR=1.7,95% CI=1.2～2.3)、孕前体质指数(BMI)(OR=1.7,95% CI=1.2～2.3)、早产史(OR=2.8,95% CI=1.3～6.0)、GDM史(OR=7.6,95% CI=3.9～14.9)、糖尿病家族史(OR=2.1,95% CI=1.1～4.0)是GDM发病的风险因素。结论产前抑郁症状与中晚期妊娠期糖尿病发病无相关性,高龄、孕前BMI、早产史、GDM史、糖尿病家族史是GDM发病的风险因素。Objective To investigate the relationship between antenatal depression symptoms and gestational diabetes mellitus (GMD) and whether antenatal depression symptoms is a risk factor for the incidence of GMD.Methods We enrolled 1 554 pregnant women taking their first prenatal examination (before 20-week of the gestation) at Guangdong Provincial Women and Children Hospital between January and September 2016. For all the participants, depressive symptoms during early pregnancy were assessed with the 10-item Edinburgh Postnatal Depression Scale (EPDS) and a 75-g oral glucose tolerance test (OGTT) was conducted to diagnose GDM in a follow-up survey between 24- and 28- week of gestation. We compared the difference in the incidence of GMD between the participants with and without depressive symptoms and explored the associations of antenatal depression symptoms with GDM and influence factors of GDM using logistic regression analysis.Results The incidence of GDM was 17.7% among all the participants and the incidence was unsignificantly higher among the participants with antenatal depression symptoms than among those without the symptoms (18.5% vs. 17.3%;χ^2=0.3, P=0.57). The results of logistic regression analysis revealed that prenatal depression was not associated with GDM (odds ratio[OR]=1.1, 95% confidence interval[95% CI]:0.82-1.43);while, age (OR=1.7, 95% CI:1.2-2.3), high pre-pregnancy body mass index (BMI) of ≥ 24.0 kg/m2 (OR=1.7, 95% CI:1.2-2.3), history of preterm delivery (OR=2.8, 95% CI:1.3-6.0), GDM history (OR=7.6, 95% CI:3.9-14.9), and family history of diabetes (OR=2.1, 95% CI:1.1-4.0) were significant risk factors of GDM.Conclusion Gestational diabetes mellitus incidence is not correlated with prenatal depression symptoms but significantly influenced by age, pre-pregnancy BMI, histories of preterm delivery and GDM, and family history of diabetes.

关 键 词：产前抑郁症状 妊娠期糖尿病 相关性 影响因素 

分 类 号：R587.1[医药卫生—内分泌] R749[医药卫生—内科学]