崇明地区妊娠期妇女糖代谢状况及与妊娠不良结局的相关性研究  

Association of glucose metabolism with adverse pregnancy outcomes in pregnant women of Chongming area

作　　者：邢寅[1] 顾红霞[1] 黄毓丽 黄慧[1] 吴一鸣[1] 秦利[1] Xing Yin;Gu Hongxia;Huang Yuli;Huang Hui;Wu Yiming;Qin Li(Department of Endocrinology,Xinhua Hospital Chongming Branch Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China;Department of Obstetrics,Xinhua Hospital Chongming Branch Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院内分泌科,202150 [2]上海交通大学医学院附属新华医院崇明分院产科,202150

出　　处：《中华内分泌代谢杂志》2022年第10期848-853,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市卫生健康委员会课题(20204Y0294)。

摘　　要：目的:通过对新华医院崇明分院妊娠期妇女糖代谢状况的回顾性分析,探讨妊娠期高血糖的危险因素及其与妊娠不良结局的相关性。方法:收集2019年9月至2021年5月在新华医院崇明分院产检并正常分娩的单胎妊娠妇女604例为研究对象,按照血糖情况分为糖耐量正常(NGTG)组和妊娠糖尿病(GDM)组,将血糖超过正常但未达到GDM诊断标准的孕妇归为血糖中间状态(ISGBG)组,分别完成问卷调查、体格检查和相关实验室检测。使用SPSS13.0系统完成统计学分析。结果:604例孕妇中GDM的发生率20.86%(126/604),ISGBG妇女占40.39%(244/604),NGTG占38.74%(234/604)。多因素 logistic回归分析显示,妊娠年龄( OR=1.092, P<0.001)、孕早期三酰甘油( OR=1.625, P=0.001)、孕早期FT 3( OR=1.995, P=0.002)是GDM的独立危险因素。ISGBG组和GDM组的妊娠期高血压发生率、剖宫产率、巨大胎儿生产率、不良妊娠结局总发生率和胎儿出生体重均较NGTG组明显增加( P<0.05或 P<0.01)。 结论:崇明地区GDM的发生率较高,ISGBG的比例更高,因其均导致妊娠不良结局增加,除了重视GDM的早期干预,对于血糖高于正常但未达到GDM诊断标准的孕妇也应加强早期管理。Objective To investigate the risk factors of hyperglycemia during pregnancy and its correlation with adverse pregnancy outcomes based on the retrospective analysis of glucose metabolism of pregnant women in Chongming area.Methods A total of 604 singleton pregnant women who underwent prenatal examination and delivered normally in the Chongming branch of Xinhua Hospital from September 2019 to May 2021 were enrolled in the study.All subjects were divided into normal glucose tolerance gestation(NGTG)group and gestational diabetes mellitus(GDM)group.Pregnant women whose blood glucose exceeded normal but did not meet the diagnostic criteria of GDM were classified into the intermediate state gestational blood glucose(ISGBG)group.Questionnaire,physical examination,and relevant laboratory tests were completed.Data were analyzed using the Statistical Product and Service Solutions 13.0(SPSS,Chicago,IL).Results The incidence rate of GDM was 20.86%(126/604),ISGBG was 40.39%(244/604),and NGTG was 38.74%(234/604)in 604 pregnant women.Multivariate logistic regression analysis showed that gestational age(OR=1.092,P<0.001),serum triglyceride(OR=1.625,P=0.001)and free T3 levels(OR=1.995,P=0.002)were independent risk factors for GDM.The incidence of pregnancy-induced hypertension,cesarean section,macrosomia,the total incidence of adverse pregnancy outcomes and fetal birth weight in ISGBG and GDM were significantly higher than those in NGTG(P<0.05 or P<0.01).Conclusion The incidence of GDM in Chongming area is high,especially higher in that of ISGBG.As both GDM and ISGBG lead to increased adverse pregnancy outcomes,early monitoring should be paid more attention to pregnant women in ISGBG in addition to the early intervention of GDM.

关 键 词：妊娠糖尿病 血糖 代谢状况 妊娠不良结局 

分 类 号：R714.256[医药卫生—妇产科学]