连云港地区妊娠期糖尿病危险因素的研究

Analysis on the risk of gestational diabetes mellitus in Lianyungang prefecture with new diagnostic criteria

目的探讨在新诊断标准下连云港地区妊娠期糖尿病(GDM)的危险因素,为加强早期干预及规范管理提供依据。方法采用回顾性研究的方法,采集2013年1月至2014年12月在连云港市妇幼保健信息平台登记并在我院建卡的2 983例孕妇资料,根据GDM发病与否分为GDM组和正常组,对两组患者的年龄、孕前BMI、糖尿病家族史、GDM史、巨大儿分娩史、多囊卵巢病史、甲状腺疾病史、乙肝表面抗原阳性、高脂血症等临床参数进行多因素非条件Logistic回归分析。结果 2 983例孕妇中,312例患有GDM,发病率为10.46%。GDM危险因素的二分类Logistic回归分析显示,GDM发病的影响因素为饮食、孕前BMI、多囊卵巢、糖尿病家族史、高血压家族史、GDM史、甲状腺疾病、高血压、高脂血症、死胎病史、胰岛素抵抗、巨大儿分娩史(P<0.05)。结论连云港地区GDM发病率为10.46%,GDM的发病和孕前BMI、高血压、高血脂症等高度相关,改变不良的饮食习惯及生活方式能降低GDM的罹患率,确保母婴健康。

Objective To investigate the correlation risk factors of gestational diabetes mellitus （GDM） in Li-anyungang in order to provide basis for early intervention and standardizing the management. Methods The clinical data of 2 983 pregnant women registered in the maternal and child health information platform in Lianyungang be-tween January 2013 and December 2014 were collected and retrospectively analyzed. The women were divided into the GDM group and control group according to whether they have GDM or not. Multi-factor unconditioned Logistic regression analysis was conducted on age, body mass index （BMI）, family history of diabetes, a history of GDM be-fore childbirth, macrosomia delivery history, history of polycystic ovary disease, thyroid disease, hepatitis B surface antigen （HBsAg）-positive, hyperlipidemia of the two groups. Results Among the 2 983 pregnant women, 312 were found with gestational diabetes, with the incidence of GDM of 10.46%. Multiariable Logistic regression analysis showed that the influence factors of the onset of GDM were diet, pregnant BMI, polycystic ovary, family history of di-abetes, family history of hypertension, history of GDM, thyroid disease, hypertension, hyperlipidemia, stillbirth, insu-lin resistance, history of macrosomia delivery （P〈0.05）.Conclusion The pathogenesis of GDM is highly correlated with BMI, hypertension, and hyperlipidemia. The incidence of GDM could be effectively reduced by changing the un-healthy eating habits and lifestyle.