北京市妊娠期糖尿病孕妇社会文化特征与巨大儿发生的关系研究  

Association between socio-cultural characteristics of pregnant women with gestational diabetes mellitus and the occurrence of macrosomia in Beijing

作　　者：赵永鲜[1] 郭默宁 武明辉[1] 贾朝霞[1] 黄丽丽[1] 王军华[1] ZHAO Yong-xian;GUO Mo-ning;WU Ming-hui;JIA Zhao-xia;HUANG Li-li;WANG Jun-hua(Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Beijing Municipal Health Big Data and Policy Research Center,Beijing 100034,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院,北京100026 [2]北京市卫生健康大数据与政策研究中心,北京100034

出　　处：《实用预防医学》2023年第5期532-535,共4页Practical Preventive Medicine

基　　金：首都卫生发展科研专项资助(首发2020-2-2111)。

摘　　要：目的 了解妊娠期糖尿病(gestational diabetes mellitus, GDM)孕妇社会文化特征与巨大儿发生的关系,为开展巨大儿的一级预防提供依据。方法 本研究为回顾性队列研究。根据系统内唯一标识码,将北京市妇幼保健网络信息系统中分娩日期在2019年4月1日-2020年1月31日之间的产妇信息与北京市住院病案首页信息系统中的住院病案首页数据进行匹配,建立由27 665例GDM孕妇组成的回顾性队列,分析巨大儿发生与孕妇社会文化特征之间的关联。结果 27 665例GDM孕妇中,2 251人分娩巨大儿(占比8.1%)。孕前体重(超重:RR=2.0,肥胖:RR=2.4)、文化程度(初中及以下:RR=1.9,高中及中专:RR=1.7)与巨大儿发生呈中等强度关联。分娩机构级别(RR=1.3)、机构所属区域(RR=1.3)与巨大儿发生呈弱关联性。调整相关因素后,logistic回归分析显示,孕前超重(OR=1.981,95%CI:1.796~2.186)、肥胖(OR=2.446, 95%CI:2.162~2.768)和较低教育文化水平(与硕士及以上文化水平相比:初中以下孕妇OR=1.317, 95%CI:1.077~1.611;高中及中专孕妇OR=1.247, 95%CI:1.041~1.493)增加巨大儿发生的风险。在二级助产机构分娩也将增加巨大儿的发生风险(OR=1.145,95%CI:1.029~1.273)。结论 孕前体重、教育文化水平以及孕期管理机构级别是GDM孕妇分娩巨大儿的影响因素之一,应针对其开展巨大儿的一级预防。Objective To investigate the relationship between socio-cultural characteristics of pregnant women with gestational diabetes mellitus(GDM)and the risk of macrosomia,and to provide a basis for the primary prevention of macrosomia.Methods This study was a retrospective cohort study.According to the unique identification code in the system,the maternal information with delivery dates between April 1,2019 and January 31,2020 collected from Beijing Maternal and Child Health Information System was matched with the first page data of inpatient medical records from the First Page Information System for Beijing Inpatient Medical Records.We established a retrospective cohort consisting of 27,665 pregnant women with GDM,and analyzed the association between the occurrence of macrosomia and socio-cultural characteristics of the pregnant women.Results Among the 27,665 pregnant women with GDM,2,251(8.1%)gave birth to macrosomia.Pre-pregnancy weight(overweight:RR=2.0,obesity:RR=2.4)and education level(junior middle school and below:RR=1.9,high school and technical secondary school:RR=1.7)were moderately associated with the occurrence of macrosomia.The levels(RR=1.3)and districts(RR=1.3)of delivery hospitals were weakly correlated with the occurrence of macrosomia.After adjusting for the related factors,logistic regression analysis showed that pre-pregnancy overweight(OR=1.981,95%CI:1.796-2.186),obesity(OR=2.446,95%CI:2.162-2.768)and low education level(compared with master level and above:pregnant women with junior middle school education and below(OR=1.317,95%CI:1.077-1.611),pregnant women with high school and technical secondary school education(OR=1.247,95%CI:1.041-1.493))increased the risk of macrosomia.The risk of macrosomia was increased in the women who delivered babies in secondary-level hospitals(OR=1.145,95%CI:1.029-1.273).Conclusion Pre-pregnancy body weight,education level and the level of delivery hospitals are one of the factors influencing macrosomia in pregnant women with GDM;and hence,targeted measures for the p

关 键 词：妊娠期糖尿病 巨大儿 发生率 社会文化因素 

分 类 号：R714.256[医药卫生—妇产科学]