长春地区妊娠期糖尿病风险预测模型的临床研究  

Clinical study on risk prediction model of gestational diabetes mellitus in changchun area

作　　者：谭育松[1] TAN Yu-Song(Changchun Obstetrics and Gynecology Hospital,Changchun,Jilin 130042,China)

机构地区：[1]长春市妇产医院,吉林长春130042

出　　处：《中国妇幼保健》2020年第16期2957-2959,共3页Maternal and Child Health Care of China

基　　金：吉林省卫生厅科研课题(2011R025)。

摘　　要：目的探讨长春地区妊娠期糖尿病(GDM)的危险因素,构建相关风险预测模型。方法分析2018年1月-2019年12月在长春市妇产医院建档进行常规产检的997例孕妇的门诊检查资料。采用问卷的形式调查研究对象的基本信息、生活习惯、家族遗传病信息、孕前体质指数(BMI)、妊娠情况(受孕形式、孕次、妊娠后体质量增加情况),收集14周前的血常规、20周前的空腹血糖情况,应用Logistic回归分析GDM的独立危险因素,建立GDM发病风险预测模型,采用受试者工作特征曲线(ROC)对该模型进行评估。结果年龄、孕前BMI、孕期体质量增加量、糖尿病家族史、辅助生殖技术、妊娠前空腹血糖和14周前红细胞参数均为GDM的独立危险因素(均P<0.05)。所建立的Logistic回归模型,利用ROC曲线检验模型预测效能提示:ROC曲线下面积为0.743,灵敏度为83.7%,特异度为78.6%。结论年龄、孕前BMI、孕期体质量增加量、糖尿病家族史、辅助生殖技术、孕20周前空腹血糖和14周前红细胞参数为GDM的独立危险因素;以上危险因素建立的风险预测模型,对长春地区孕妇发生GDM的预测价值较高,为GDM高危患者的早期筛查、密切监测及干预管理提供依据。Objective To explore the risk factors of gestational diabetes mellitus( GDM) in Changchun City,and to construct the related risk prediction model. Methods The data of 997 cases of pregnant women in Changchun Obstetrics and Gynecology Hospital from January 2018 to December 2019 was analyzed. The questionnaire was used to investigate the basic information,living habits,family genetic disease information,pregestational BMI,pregnancy situation( form of pregnancy,times of pregnancy,weight gain after pregnancy). Blood routine test before 14 weeks and fasting blood glucose before 20 weeks were collected. Logistic regression was used to analyze the independent risk factors of GDM and establish GDM. The risk prediction model was evaluated by receiver operating characteristic curve( ROC).Results Age,BMI before pregnancy,weight gain during pregnancy,family history of diabetes mellitus,assisted reproductive technology,fasting blood glucose before pregnancy and erythrocyte parameters before 14 weeks were independent risk factors of GDM( all P<0. 05). The results showed that the area under the ROC curve was 0. 743,the sensitivity was 83. 7%,and the specificity was 78. 6%. Conclusion Age,BMI before pregnancy,weight gain during pregnancy,family history of diabetes mellitus,assisted reproductive technology,fasting blood glucose before 20 weeks of pregnancy and red blood cell parameters before 14 weeks are independent risk factors of GDM;The risk prediction model established by the above risk factors has higher predictive value for GDM in pregnant women in Changchun area,which provides the basis for early screening,close monitoring and intervention management of GDM high-risk patients.

关 键 词：妊娠期糖尿病 危险因素 LOGISTIC回归分析 预测风险模型 

分 类 号：R714.256[医药卫生—妇产科学]