妊娠糖尿病危险性因素分析及预防对策  

Risk factors and preventive measures of gestational diabetes mellitus

作　　者：曾琼静 吴逸[1] 解其贵[1] 张稼闻 周健红[1] 丘瑾[1] ZENG Qiongjing, WU Yi, JIE Qigui, ZHANG Jiawen, ZHOU Jianhong, QIU Jin.(Department of Obstetrics and Gynecology, Shanghai Tenth Hospital, Shanghai 200027, Chin)

机构地区：[1]上海市第十人民医院

出　　处：《中国妇产科临床杂志》2018年第3期217-219,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：上海市卫生和计划生育委员会科研课题(20164Y0190)

摘　　要：目的探讨妊娠期糖尿病（Gestationaldiabetes mellitus，GDM）发病危险因素及预防措施。方法收集2016年1月至2016年12月在上海市第十人民医院分娩的2729例孕妇资料进行分析；选取同期诊断为糖尿病的足月妊娠妇女148例，年龄20—40岁，平均（32．7±3．8）岁；排除糖尿病合并妊娠及其他系统性并发症孕妇26例；同时，随机选取同期人院的足月正常妊娠妇女122例作为对照，对妊娠年龄、孕前人体质量指数（BMI）、孕期增重、身高、孕次、适龄妇女经期及家庭经济月收入等因素进行Logistic或t检验等统计学分析。结果通过对比122例GDM孕妇和122例足月正常妊娠妇女，发现GDM和妊娠年龄、孕前BMI及孕期增重均为孕妇罹患糖尿病的危险因素（P〈0．05）；并且，通过对2729例孕妇进行分析发现，随着高危因素数目的增加，GDM发病率也呈现逐渐增加趋势；无高危因素孕妇GDM发病率为2．5％（23／920），当危险因素累计3项时，孕妇GDM发病率达到9．4％，是无高危因素的3．84倍。结论适龄期受孕，控制体重及降低孕前BMI指数能够降低GDM发病率；并且，对高危孕妇进行早期糖耐量筛查能够为临床预防GDM提供指导。Objective To investigate population-specific risk factors and prophylactic measures for gestational diabetes mellitus （GDM） in a large-scale general hospital in Shanghai. Methods 2 729 cases of pregnant women hospitalized in the Obstetrics and Gynecology department of our hospital from January to December in 2016 were analyzed. 148 cases of full-term pregnant women, age from 20 to 40 years old, were diagnosed Diabetes, including 26 cases who has gestational diabetes and other systemic complications removed finally. At the same time, 122 cases of normal full-term pregnant women in gestational age were chosen as control at random. Pre-pregnancy body mass index （BMI） during pregnancy, weight, height, age, age of women in the menstrual period and the family economic income and other relevant factors were analyzed by Logistic or t test statistics. Results The comparison of 122 GDM pregnant women with 122 normal full-term pregnant women showed that, the pregnant age, BMI and pregnancy weight gain during pregnancy were risk factors of diabetes mellit!as （P〈0.05）. According to the analysis of the iotal 2729 pregnant women, with the increase of the risk factors, the incidence of GDM gradually increased. The incidence of GDM in pregnant women with no risk factor was only 2.5% （23/920）, but the incidence rate reached 9.4% with 3 or more risk factors, 3.84 times higher. Conclusion The appropriate gestational age of pregnancy, a proper diet and regular exercise to reduce pre- pregnancy BMI index, glucose loading tests in pregnant women, especially early screening for high risk factors, could effectively reduce the incidence of diabetes in pregnancy.

关 键 词：妊娠糖尿病 危险因素 预防措施 

分 类 号：R714.256[医药卫生—妇产科学]