深圳地区初产妇妊娠期糖尿病发病现状及危险因素分析  

Incidence and risk factors of gestational diabetes mellitus among primiparae in Shenzhen

作　　者：许佳章[1,2] 张红敏 于微 李艳艳[1] 李敬光 刘小立 王俊[1] 

机构地区：[1]深圳市慢性病防治中心,广东深圳518020 [2]深圳市新建市属医院筹备办公室,广东深圳518000 [3]国家食品安全风险评估中心,北京100021

出　　处：《中国热带医学》2017年第12期1214-1217,1239,共5页China Tropical Medicine

基　　金：国家自然科学基金(No.21477030;81673168);广东省医学基金(No.A2016130;A2017206);深圳市卫生计生系统科研项目(No.201507040;201606043;201605016)

摘　　要：目的调查深圳地区初产孕妇妊娠期糖尿病(gestational diabetes mellitus,GDM)的发病情况,分析影响GDM发病的危险因素,为GDM的预防、管理和早期干预提供理论依据。方法以2015年11月至2016年1月在深圳市妇幼保健院产检建卡的孕11~16周初产孕妇为研究对象,所有研究对象通过问卷调查收集一般资料,于孕24~28周行75 g口服葡萄糖耐量试验,采用Logistic回归分析法探讨GDM的危险因素。结果参与调查的600名初产妇中,有543名完成问卷调查和血糖检测,按照2010年国际糖尿病与妊娠研究组诊断标准,检出GDM患者37例,发生率6.8%。GDM组孕妇年龄、孕前BMI和建卡时体重均高于糖耐量正常(NGT)组(P<0.05);孕前超重及肥胖孕妇GDM发生率为17.1%,明显高于孕前体重正常孕妇(7.0%)和孕前体重偏低孕妇(3.2%),家庭收入较高的孕妇GDM发生率为14.7%,高于家庭收入中等(8.0%)和偏少(4.0%)的孕妇,每日静坐时间≥5 h孕妇GDM发生率高于静坐时间<5 h孕妇(8.0%vs 2.5%),差异均有统计学意义(P<0.05)。Logistic回归分析结果显示初产妇孕前BMI(OR=1.190;95%CI=1.044~1.356)、年龄(OR=1.108;95%CI=1.011~1.215)和每日静坐时间≥5 h(OR=3.741;95%CI=1.108~12.632)是GDM发生的危险因素。结论年龄、孕前BMI和每日静坐时间≥5 h是初产孕妇GDM发生的独立危险因素。深圳地区应尽早对初产妇进行高危因素筛查,加强管理,以减少GDM的发生。Objective To investigate the incidence of gestational diabetes mellitus（GDM） in Shenzhen region andexplore its associated risk factors, so as to provide a theoretical evidence for the prevention, management and early interventionof GDM. Methods A questionnaire survey was conducted among the primiparae having prenatal check in ShenzhenMaternity and Child Health Hospital from November 2015 to January 2016 and the results of 75 g oral glucose tolerance test（OGTT） during 24 to 28 weeks＇ gestation were collected. The logistic regression analysis was used to analyze the risk factors forGDM. Results Among the 600 primiparae who took part in the survey, 543 of them completed questionnaires and OGTT.According to the diagnostic criteria of International Association of Diabetes and Pregnancy Study Groups, 37 women weredetected for GDM（6.8%）. The average age, pre-pregnancy BMI and weight were much higher in the GDM group than those inthe normal glucose tolerance（NGT） group（P〈0.05）. The incidence of GDM in the pre-pregnancy overweight and obese women（17.1%） was much higher than that in the normal pre-pregnancy weight（7.0%） and low pre-pregnancy weight women（3.2%）（P〈0.05）. The incidence of GDM in the high-income pregnant women（14.7%） was higher than that in the middle-incomewomen（8.0%） and low-income women（4.0%）. The incidence of GDM in the sedentary time ≥5 h was higher than that in thesedentary time〈5 h（8.0% vs 2.5%, P〈0.05）. The logistic regression analysis showed that the age（OR=1.108; 95%CI=1.011-1.215）, pre-pregnancy BMI（OR=1.190; 95%CI=1.044-1.356） and sedentary time ≥5 h（OR=3.741; 95%CI=1.108-12.632）were risk factors for GDM. Conclusion The age, pre-pregnancy BMI and sedentary time ≥5 h are the independent risk factorfor GDM. Therefore, the screening and early management for pregnant women with risk factors should be strengthened in orderto reduce the incidence of GDM in Shenzhen region.

关 键 词：妊娠期糖尿病 危险因素 初产妇 

分 类 号：R587.1[医药卫生—内分泌]