“一步法”诊断妊娠期糖尿病研究

Research of gestational diabetes situation under the "one-step" diagnosis

目的：调查新诊断标准下大连开发区妊娠期糖尿病（ GDM）的发病情况。分析影响GDM的高危因素，为新诊断标准下GDM孕妇临床早期管理、诊断和干预提供理论依据。方法对2012年11月-2013年6月来大连开发区妇幼保健院接受产检，并于24～28周进行糖尿病筛查的孕妇1132例进行临床资料的收集及回顾性研究，采用GDM诊断新标准进行“一步法”诊断。收集年龄、孕次、产次、体重指数（ body mass index， BMI）、糖尿病家族史等因素，进行综合分析。结果新诊断标准下GDM检出率为12.07％（136/1132）。分析结果显示年龄≥35岁（χ^2＝7.81，P＜0.05）、体重指数≥28 kg/m2（χ^2＝455.01，P＜0.001）、糖尿病家族史（χ^2＝4.53，P＜0.05）在GDM组与非GDM组差异有显著性意义。结论新诊断标准下大连开发区孕妇GDM检出率为12.07％。对肥胖、高龄、糖尿病家族史的孕妇应加强管理，以减少母婴合并症的发生。

Objective To investigate the incidence of gestational diabetes in Dalian Development Zone under the new diagnostic criteria.To provide a theoretical basis of early clinical management , diagnosis and intervention for local GDM women under the new standard .Methods Totally 1132 cases of pregnant women , who had prenatal check and diabetes screening at 24-28 gestational weeks in our hospital between November 2012 and April 2013 were recruited in this retrospective study. GDM was diagnosed based on the new criteria of ＆quot;one-step＆quot;diagnosis .We collected the clinical data including age , number of pregnancy, number of parity, body mass index （BMI）, family history of diabetes etc, and performed comprehensive analysis.Results According to the new standard , 12.07%（136/1132）pregnant women were diagnosed with GDM . Univariate analysis indicated that age≥35（χ2 =7.81,P〈0.05）, BMI≥28 kg/m2（χ2 =455.01,P〈0.001）, and family history of diabetes（χ2 =4.53,P〈0.05） were significantly different between GDM group and non -GDM group.Conclusion 12.07%（136/1132）pregnant women were detected for GDM under the new standard in Dalian Development Zone . Pregnant women with obesity , older age , and family history of diabetes should be closely monitored , in order to reduce the occurrence of maternal and infant complications .