中国西部农村孕妇妊娠期糖尿病认知现状及影响因素分析  

Pregnant women’s cognition of gestational diabetes mellitus in rural areas of western China and its influencing factors

作　　者：徐婷婷 雷艳芳 马梦凡 夏青 张汉莉 王银翠 张忍萍 尹春梅 向兴梅 方海[8] XU Tingting;LEI Yanfang;MA Mengfan;XIA Qing;ZHANG Hanli;WANG Yincui;ZHANG Renping;YIN Chunmei;XIANG Xingmei;FANG Hai(School of Public Health,Capital Medical University,Beijing 100069,China;Department of Obstetrics and Gynecology,Zhaotong Second People’s Hospital,Zhaotong,Yunnan 657000,China;Menzies Institute for Medical Research,University of Tasmania,Tasmania 7000,Australia;Department of Obstetrics and Gynecology,Hanyin Maternal and Child Healthcare Hospital,Hanyin,Shaanxi 725100,China;Department of Obstetrics and Gynecology,Yiliang Maternal and Child Healthcare Hospital,Yiliang,Yunnan 657600,China;Department of Obstetrics and Gynecology,Yingshan Maternal and Child Healthcare Hospital,Yingshan,Sichuan 637700,China;Department of Obstetrics and Gynecology,Pingchang Maternal and Child Healthcare Hospital,Pingchang,Sichuan 635400,China;School of Public Health,Department of Medicine,Peking University,Beijing 100191,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]昭通市第二人民医院妇产科,云南昭通657000 [3]塔斯马尼亚大学Menzies研究所,澳洲7000 [4]汉阴县妇幼保健医院妇产科,陕西汉阴725100 [5]彝良县妇幼保健医院妇产科,云南彝良657600 [6]营山县妇幼保健院妇产科,四川营山637700 [7]平昌县妇幼保健院妇产科,四川平昌635400 [8]北京大学医学部公共卫生学院,北京100191

出　　处：《中国农村卫生事业管理》2022年第5期375-380,共6页Chinese Rural Health Service Administration

基　　金：China Medical Board(17-266);达能营养中心膳食营养研究与宣教基金(DIC2018-03)。

摘　　要：目的分析农村地区孕妇妊娠期糖尿病认知水平及其影响因素,为农村地区普及妊娠期糖尿病筛查提供研究基础。方法2018年9月—2019年9月在陕西、四川、云南的6个县级医疗机构以整群抽样抽取中期孕妇,采用自制调查问卷调查其认知水平和影响因素。采用Stata 14.0分析不同特征孕妇的妊娠期糖尿病认知水平,并应用多重线性回归进行影响因素分析。结果该研究共纳入3294名孕妇。平均年龄为27.1±5.0岁。认知分析结果显示:接近一半的孕妇(42.7%)对GDM不甚了解。孕妇平均认知得分为48.2±15.7。孕妇产次、孕前BMI和糖尿病家族史对孕妇认知没有影响,而教育程度、家庭收入、居住地、职业以及GDM宣教对孕妇妊娠期糖尿病认知具有显著性影响。其中教育水平(高中vs初中,β:6.8,P<0.01)和家庭收入越高的孕妇(>10万vs<5万,β:3.5,P<0.01),认知得分越高。在控制了教育、年龄、产次、家庭收入等因素后,医疗机构宣教频次对农村孕妇的妊娠期糖尿病认知仍然具有显著影响。结论农村地区孕妇妊娠期糖尿病认知水平整体较低,年龄较大和有生育经历的孕妇对妊娠期糖尿病认知并不比低龄和初产孕妇更好。全面加强宣教对提高农村孕妇认知和妊娠期糖尿病筛查管理水平具有重要意义。Objective To analyze pregnant women’s cognition of gestational diabetes mellitus(GDM)and to further explore its influencing factors,so as to provide basis for improving the rate of GDM screening in rural areas of western China.Methods We recruited mid-trimester pregnant women using cluster sampling,who sought medical service between September 2018 and September 2019 in six county hospitals located in three provinces(i.e.,Shaanxi,Sichuan,Yunnan)in western China.Data were collected using self-designed questionnaire.Stata 14.0 was used for the analysis of cognition of GDM among pregnant women with different features.Multivariate regression was used to analyze the influencing factors.Results A total of 3294 pregnant women were enrolled,with a mean age of 27.1±5.0 years old and near half of women(42.7%)have weak cognition of GDM.The mean score of pregnant women’s GDM cognition was 48.2±15.7.Women’s parity,pre-pregnant BMI and family history of diabetes were not associated with women’s GDM cognition,while education,household income,residency,occupation and publicity of GDM had significant influence on their cognition.Women with higher educational level(high school vs.middle school,β:6.8,P<0.01)and higher household income(>100 thousand CNY vs.<50 thousand CNY,β:3.5,P<0.01)had higher cognition scores.Health education frequency of medical institutions still had significant influence on women’s cognition of GDM after adjusting such factors as women’s education,age,parity,and household income.Conclusions The overall cognitive scores of GDM for women was low in rural China.Age and childbearing experience did not improve the women’s cognition of GDM.Health education was of great significance for the improvement in women’s cognition of GDM and management of GDM screening.

关 键 词：妊娠期糖尿病 认知 影响因素研究 农村孕妇 血糖管控 社会经济 

分 类 号：R17[医药卫生—妇幼卫生保健] R587.1[医药卫生—公共卫生与预防医学]