GDM孕妇产后糖代谢转归失败危险因素分析及预测价值  

Risk factors analysis of the failure of the postpartum glucose metabolism turning to normal of pregnant women with gestational diabetes mellitus and their predictive values

作　　者：陈红惠 陆卫[1] CHEN Honghui;LU Wei(Maternity and Child Health Care Hospital Affiliated to Nantong University,Jiangsu Province,226000)

机构地区：[1]南通大学附属妇幼保健院,226000

出　　处：《中国计划生育学杂志》2024年第3期680-684,共5页Chinese Journal of Family Planning

摘　　要：目的:分析妊娠期糖尿病(GDM)孕妇产后糖代谢转归失败危险因素及其预测价值。方法:选取2021年3月-2023年5月在本院产科就诊的GDM患者214例临床资料,依据产后6~12周糖代谢转归情况分为转归失败组、转归正常组。收集患者孕前、孕期、新生儿资料,通过多因素logistic回归分析确定患者产后糖代谢转归失败的独立危险因素,受试者工作特征(ROC)曲线观察独立危险因素预测产后糖代谢转归失败价值。结果:年龄、孕前BMI、糖尿病家族史、FPG、HbA1c及孕期使用胰岛素均为产后糖代谢转归失败的独立危险因素(P<0.05)。ROC曲线显示,年龄≥35岁、孕前体质指数≥24 kg/m^(2)、糖尿病家族史、空腹血糖、糖化血红蛋白及孕期使用胰岛素均对GDM孕妇产后糖代谢转归失败有一定预测效能,曲线下面积(AUC)分别为0.582、0.590、0.638、0.858、0.651、0.609(均P<0.05)。结论:GDM孕妇产后糖代谢转归失败与年龄大、孕前BMI高、糖尿病家族史、血糖指标高、孕期使用胰岛素有关,且上述因素均对转归失败有一定预测价值。Objective:To analyze the risk factors of the failure of the postpartum glucose metabolism turning to normal of pregnant women with gestational diabetes mellitus(GDM),and to observe the of these risk factors for the failure of the postpartum glucose metabolism turning to normal of the women.Methods:A retrospective analysis was performed on 214 women with GDM who were treated in hospital from March 2021 to May 2023.According to the glucose metabolism the glucose metabolism turning to normal or not in postpartum 6-12 weeks,these women were divided into group A(women with the failure of the postpartum glucose metabolism turning to normal)and group B(women with the successes of the postpartum glucose metabolism turning to normal).The data of the women at pre-pregnancy and during pregnancy,and the data of the neonates of the women in the two groups were collected.Multivariate Logistic regression analysis was used to determine the independent risk factors of the failure of the postpartum glucose metabolism turning to normal of the women.The predictive value of the independent risk factors of the women for the failure of their postpartum glucose metabolism turning to normal was observed by receiver operating characteristic(ROC)curve.Results:The age,the pre-pregnancy BMI value,the family history of diabetes,the levels of fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c),and the insulin used during pregnancy of the women were all the independent risk factors of their failure of the postpartum glucose metabolism turning to normal(P<0.05).ROC curve showed that,the age≥35 years old,the pre-pregnancy body mass index≥24 kg/m^(2),the family history of diabetes,the levels of FPG and HbA1c,and the insulin used during pregnancy of the women with GDM had certain predictive efficacy for their failure of the postpartum glucose metabolism turning to normal,and the area under the curve(AUC)of which were 0.582,0.590,0.638,0.858,0.651and 0.609,respectively(all P<0.05).Conclusion:The age,the pre-pregnancy BMI,the family hist

关 键 词：妊娠期糖尿病 产后糖代谢转归 危险因素 预测 

分 类 号：R714.256[医药卫生—妇产科学]