妊娠糖代谢异常相关危险因素研究

A prospective study of risk factors associated with abnormal glucose metabolism in pregnants

目的探讨妊娠糖尿病（GDM）及妊娠糖耐量低减（GIGT）发病的高危因素。方法采用回顾性多因素分析方法，对GDM56例（GDM组）、GIGT34例（GIGT组）和90例糖代谢正常孕妇（对照组）的临床资料进行单因素及多因素logistic回归分析，探讨各因素对GDM和GIGT发病的影响。结果GDM组及GIGT组孕妇平均年龄、孕前体重指数、确诊前孕妇平均每周体重增长均高于对照组（P〈0．01）；GDM组及GIGT组孕妇孕次、既往产次及不良孕产史与对照组比较，差异有统计学意义（P〈0．05～0．01）；GDM组及GIGT组糖尿病家族史发生率与对照组比较，差异有统计学意义（P〈0．01）；多因素logistic回归分析显示，孕妇年龄、孕前体重指数和孕期体重增加过快均为妊娠糖代谢异常的高危因素。结论孕妇年龄、孕前体重指数和孕期体重增加过快为GDM和GIGT发病的独立高危因素。多次妊娠、不良孕产史及糖尿病家族遗传史对GDM和GIGT发病有一定影响，但不是独立高危因素。

Objective To evaluate the risk factors of gestational diabetes diabetes mellitus （GDM） and gestational impaired glucose tolerance（GIGT） . Methods A case - control study was performed in 56 women with GDM, 34 cases with GIGT and 90 cases as control recruited. Univariate analysis and multivariate logistic regression were used to identify risk factors of GDM and CIGT. Results The mean age, and body mass index（BMI） before pregnancy and larger matemal weight gains during pregnancy were significantly different between GDM/GIGT and control group （ P 〈 0.01 ） ; Gravidity, past parity and cacogenesis were significantly different between GDM/GIGT and control group （ P 〈 0.05 - 0.01 ） ; There was a higher proportion of women with family history of diabetes among the GDM and GIGT compared with control group （P 〈 0.01 ）; Multivariate logistic regression showed that age, BMI before pregnancy and larger matemal weight gains during pregnancy were independent high risk factors for GDM or GIGT. Conclusion Maternal age, obesity before gestation and rapid weight gains during pregnancy are independent risk factors for GDM or GIGT. Time after time procreation, cacogenesis and family history of diabetes increase the incidence of GDM and GIGT, but these are not independent risk factors for GDM and GIGT.