妊娠期糖尿病影响因素的病例对照研究

Case-control study on effect factors of gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)发病的影响因素,为预防和治疗GDM的发生和发展提供理论依据。方法:采用回顾性分析的方法,将2007年9月～2008年9月在沈阳市盛京医院住院的129例GDM孕产妇与129例正常孕产妇(均为初产妇、单胎妊娠、汉族)按1∶1的比例进行病例对照研究。结果:单因素分析结果显示,孕产妇怀孕年龄、孕前体重指数(BMI)、孕后期体重、文化程度、早起时间、晚睡时间、孕前口味、孕前常饮饮料、怀孕胎次、糖尿病(DM)家族史、高血压家族史、孕前高脂血症、孕前运动、流产史在两组间的差异均有统计学意义。经过Logistic回归分析,有5项因素进入回归模型即怀孕年龄、孕前BMI、DM家族史和孕前口味为危险因素(P=0.000,OR=1.861,95%C.I为1.795～1.932,P=0.000,OR=2.750,95%C.I为1.660～2.852,P=0.000,OR=8.690,95%C.I为3.588～21.046,P=0.000,OR=1.615,95%C.I为1.503～3.750);文化程度为保护因素(P=0.002,OR=0.910,95%C.I为0.259～0.898)。结论:孕产妇怀孕年龄、孕前BMI、DM家族史、孕前高盐和高热量的饮食习惯可能是GDM的危险因素,文化程度是GDM的保护因素。

Objective： To explore the effect factors of gestational diabetes mellitus （ GDM）, provide a scientific basis for the prevention and treatment of GDM. Methods： A casecontrol study was conducted on 129 women with GDM and 129 healthy pregnant women from September 2007 to September 2008 by retrospective analysis method. Results： Univariate analysis showed that there was significant difference between case group and control group in maternal age, body mass index （BMI） before pregnancy, body weight in third trimester, educational background, getting up and sleeping time, eating habits before pregnancy, pregnant times, family history of diabetes mellitus and hypertension, hyperlipoidemia before pregnancy, sports time before pregnancy, the history of miscarriage. The risk factors of GDM included maternal age, BMI before pregnancy, family history of diabetes mellitus, unreasonable drinking and eating habits before pregnancy （P=0.000, OR=1.861,95%CI=1.795-1.932, P=0.000, OR=2.750,95%CI=1.660-2.852, P=0.000, OR=8.690, 95% CI = 3. 588 - 21. 046, P = 0. 000, OR = 1. 615, 95% CI = 1. 503 - 3.750） ; the protective factor was educational background （P = 0. 002, OR = 0. 910, 95% CI = 0. 259 - 0. 898 ） . Conclusion ： Maternal age, BMI before pregnancy, family history of diabetes mellitus, unreasonable drinking and eating habits before pregnancy are risk factors of GDM, while educational background is a protective factor of GDM.