妊娠糖尿病发生的危险因素及其对不良妊娠结局的影响  

Risk factors of gestational diabetes mellitus and its influence on adverse maternal and infant pregnancy outcomes

作　　者：黄丽萍[1] 林琳[1] HUANG Liping;LIN Lin(Department of Obstetrics and Gynecology,Fujian Maternity and Child Health Hospital,College of Clinical Medicine for Obstetrics&Gynecology and Pediatrics,Fujian Medical University,Fujian Province,Fuzhou350001,China)

机构地区：[1]福建省妇幼保健院产科福建医科大学妇儿临床医学院,福建福州350001

出　　处：《中国当代医药》2024年第20期73-77,共5页China Modern Medicine

基　　金：福建省卫生健康委员会医学创新课题(A类)(2020CXA017)。

摘　　要：目的探讨妊娠糖尿病(GDM)发生的危险因素及其对不良妊娠结局的影响。方法选取2022年6月至2023年3月在福建省妇幼保健院产科建档并住院分娩的548例GDM孕妇作为病例组,从同期就诊的非GDM孕妇中抽取2192例作为对照组,所有研究对象年龄介于20~44周岁、单胎、初产妇、分娩孕龄≥28周。收集其一般资料,采用条件logistic回归模型分析发生GDM的危险因素,并比较分析不同组别不良妊娠结局的差异。结果单因素分析结果显示,GDM孕妇的孕前体重指数(BMI)和妊娠年龄均高于非GDM孕妇,GDM孕妇的分娩孕龄低于非GDM孕妇,GDM孕妇的妊娠高血压发生比例高于非GDM孕妇,差异均有统计学意义(P<0.05)。进一步多因素条件logistic回归分析显示:孕前肥胖(β=1.147,OR=3.150,95%CI:2.180~4.551)和孕前超重(β=0.488,OR=1.629,95%CI:1.112~2.386)、妊娠年龄≥35周岁(β=0.870,OR=2.387,95%CI:1.381~4.123)、患有妊娠期高血压(β=1.230,OR=3.421,95%CI:1.850~6.326)是发生GDM的独立危险因素(P<0.05),而分娩孕龄(β=-0.097,OR=0.907,95%CI:0.868-0.948)是GDM的保护因素(P<0.05)。GDM孕妇剖宫产、胎膜早破、低出生体重儿和早产儿的发生率均高于非GDM孕妇,差异均有统计学意义(P<0.05)。结论GDM孕妇的妊娠结局较差,应加强对GDM的监测与管理,对有GDM危险因素的高危孕妇应进行早期筛查,及时干预和诊断,避免不良妊娠结局的发生。Objective To investigate the risk factors of gestational diabetes mellitus(GDM)and its influence on adverse pregnancy outcomes.Methods A total of 548 pregnant women with GDM registered and delivered in Department of Obstetrics and Gynecology of Fujian Maternity and Child Health Hospital from June 2022 to March 2023 were selected as the case group,and 2192 normal pregnant women who visited this hospital during the same period were selected as the control group.All the objects were 20-44 years old,single,primipara,and the gestational age of delivery was≥28 weeks.The general data were collected,the risk factors of gestational diabetes was analyzed by conditionallogistic regression method,and the difference between different groups of adverse maternal and infant pregnancy outcome was compared.Results The pre-pregnancy body mass index(BMI)and gestational age of GDM women were higher than those of non-GDM women,and the gestational weeks of GDM pregnant women were lower than those of non-GDM women,the incidence of gestational hypertension in GDM was higher than that in non-GDM(P<0.05).Multivariate logistic regression analysis showed that,pre-pregnancy obesity(β=1.147,OR=1.481,95%CI:1.331-1.647),gestational age≥35 years(β=0.488,OR=2.387,95%CI:1.381-4.123),gestational hypertension(β=1.230,OR=3.421,95%CI:1.850-6.326)were independent risk factors for developing gestational diabetes,while gestational week of delivery(β=-0.097,OR=0.907,95%CI:0.868-0.948)was a protective factor for gestational diabetes.The incidences of cesarean section,premature rupture of membranes,low birth weight infants and preterm infants with GDM were higher than those without GDM,and the differences were statistically significant(P<0.05).Conclusion Pregnant women with GDM have poor pregnancy outcomes,so monitoring and management of GDM should be strengthened,and early screening,timely intervention and diagnosis should be carried out for high-risk pregnant women with GDM risk factors to avoid adverse pregnancy outcomes.

关 键 词：初产妇 妊娠糖尿病 危险因素 妊娠结局 

分 类 号：R781.64[医药卫生—口腔医学]