112例孕妇孕期体质量增长与妊娠期糖尿病发生的相关性研究

The correlation between weight gain during pregnancy and occurrence of gestational diabetes mellitus in 112 pregnant women

目的分析112例孕妇孕期体质量增长情况与妊娠期糖尿病(GDM)发生的相关性。方法收集2016年11月~2017年12月在台州医院确诊的112例单胎GDM孕妇,选择同期进行产前检查的448例健康单胎孕妇为对照组。记录两组孕妇的妊娠年龄、糖尿病家族史、文化程度、产次、孕前BMI、分娩前BMI以及孕期BMI增长情况;采用logistic回归分析影响GDM发生的危险因素;采用Pearson分析妊娠年龄、分娩前BMI、孕期BMI增加与GDM发生之间的相关性;采用受试者工作特征曲线(ROC)分析孕期BMI增加对GDM发生的预测价值,曲线下面积(AUC)表示预测价值。结果GDM的发生与产妇的妊娠年龄、糖尿病家族史、孕前BMI、分娩前BMI和孕期BMI增长有关(P<0.05);妊娠年龄增加(OR=1.923,P=0.038)、分娩前BMI增加(OR=2.130,P=0.026)、孕期BMI变化增加(OR=2.214,P=0.018)均为影响孕妇GDM发生的独立危险因素;相关性分析,妊娠年龄增加(r=0.170,P<0.001)、分娩前BMI增加(r=0.299,P<0.01)、孕期BMI变化增加(r=0.490,P<0.01)均与孕妇GDM发生呈显著的正相关关系;ROC分析显示,孕期BMI增长预测孕妇GDM发生的AUC为0.851。结论孕期体质量增长是孕妇GDM发生的独立危险因素,对GDM的发生具有较高的预测价值。

Objective To analyze the correlation between weight gain during pregnancy and occurrence of gestational diabetes mellitus(GDM)in 112 pregnant women.Methods A total of 112 confirmed GDM patients with single birth from November 2016 to December 2017 were recruited in our study.Meanwhile,448 healthy single birth pregnant women who underwent prenatal examination in our hospital during the same period were enrolled as study controls.The pregnancy age,family history of diabetes mellitus,education level,parity,pre-gestational BMI,pre-birth BMI,and BMI growth during pregnancy in both groups were recorded.Logistic regression analysis was performed for GDM related risk factors and Pearson analysis was performed to determine the association of pregnancy age,pre-birth BMI,BMI growth during pregnancy and occurrence of GDM.The area under the curve(AUC)in the receiver operating characteristic(ROC)curve was used to assess the predictive value of BMI growth during pregnancy for the occurrence of GDM.Results The maternal pregnancy age,family history of diabetes mellitus,pre-gestational BMI,pre-birth BMI and BMI growth during pregnancy were related to the occurrence of GDM(P<0.05).The older pregnancy age(OR=0.023,P=0.038),increase of pre-birth BMI(OR=0.130,P=0.026)and BMI growth during pregnancy(OR=0.214,P=0.018)were all independent risk factors of maternal GDM.Correlation analysis showed that increase of pregnancy age(r=0.170,P<0.001),increase of pre-birth BMI(r=0.299,P<0.001)and BMI increase during pregnancy(r=0.490,P<0.001)were positively correlated with the occurrence of maternal GDM.ROC analysis showed AUC of BMI increase during pregnancy for predicting occurrence of maternal GDM was 0.851.Conclusions Weight gain during pregnancy is an independent risk factor for the occurrence of maternal GDM,which is of great value for the prediction of GDM.