妊娠期糖尿病不良妊娠结局的相关影响因素分析  

Analysis of Related Factors Influencing the Adverse Pregnancy Outcome of Gestational Diabetes

作　　者：刘继群 LIU Ji-qun(Department of Obstetrics and Gynecology,Second People's Hospital of Longgang District,Shenzhen,Guangdong Province,518000 China)

机构地区：[1]深圳市龙岗区第二人民医院产科,广东深圳518000

出　　处：《糖尿病新世界》2020年第21期9-11,共3页Diabetes New World Magazine

摘　　要：目的探讨影响妊娠期糖尿病(gestational diabetes mellitus,GDM)患者不良妊娠结局的危险因素。方法选取2017年1月—2018年12月在龙岗区第二人民医院产科规范产前检查并分娩的200例妊娠期糖尿病孕妇作为研究组,根据是否发生不良妊娠结局,将这200例GDM患者分为无不良妊娠结局组106例(53%)及有不良妊娠结局组94例(47%),分析这些孕妇的年龄、孕前体质量指数(BMI)、孕期增重、口服葡萄糖耐量值(OGTT)、OGTT时间-血糖曲线下面积、糖化血红蛋白等临床指标。结果不良妊娠结局组中年龄≥35岁、BMI≥28 kg/m^2、孕期增重≥16 kg、HbA1c≥5.6%、AUC≥13 mmol/(L·h)的比例均高于无不良妊娠结局组,差异有统计学意义(P<0.05)。OGTT中3个时间点血糖值差异无统计学意义(P>0.05),但不良妊娠结局组血糖水平明显升高;Logistic二元分析法孕前BMI≥28 kg/m^2(OR=7.583,95%CI=1.198~48.004),AUC≥13 mmol/(L·h)(OR=3.354,95%CI=1.226~9.177)是妊娠期糖尿病孕妇孕期发生不良妊娠结局的危险因素。结论AUC≥13 mmol/(L·H)及孕前BMI≥28 kg/m^2是GDM孕妇发生不良妊娠结局的危险因素。临床工作中,应及早进行临床干预,分层次管理,降低不良妊娠结局的发生率。Objective To explore the risk factors that affect the adverse pregnancy outcome of patients with gestational diabetes mellitus(gestational diabetes mellitus,GDM).Methods A tatal of 200 cases of pregnant women with gestational diabetes mellitus who received standard prenatal examination and delivered in the second people’s hospital of Longgang district from January 2017 to December 2018 were selected as the study group.According to whether adverse pregnancy outcomes,the 200 GDM patients were divided into 106(53%)patients without adverse pregnancy outcomes and 94(47%)patients with adverse pregnancy outcomes.The clinical indicators,including age,pre-pregnancy body mass index(BMI),gestational weight gain,oral glucose tolerance test(OGTT),area under the curve(AUC)of OGTT and glycosylated hemoglobin.Results The age≥35 years old,BMI≥28 kg/m^2,gestational weight gain≥16 kg,HbA1c≥5.6%,AUC≥13 mmol/(L·h)in the adverse pregnancy outcome group were higher than those in the non-adverse pregnancy outcome group,the difference was statistically significant(P<0.05).There was no significant difference in blood glucose among the 3 time points of OGTT(P>0.05),but the blood glucose level in the group with adverse pregnancy outcome was significantly higher;BMI≥28 kg/m^2(OR=7.583,95%CI=1.198-48.004),AUC≥13 mmol/(L·h)(OR=3.354,95%CI=1.226-9.177)were the risk factors of adverse pregnancy outcome in the group with gestational diabetes mellitus.Conclusion AUC≥13 mmol/(L·h)and pre-pregnancy BMI≥28 kg/m^2 are risk factors for adverse pregnancy outcome in GDM patients.In clinical work,early clinical intervention and management should be carried out to reduce the incidence of adverse pregnancy outcomes.

关 键 词：妊娠期糖尿病 妊娠结局 口服葡萄糖耐量试验 曲线下面积 

分 类 号：R587.2[医药卫生—内分泌]