妊娠前体质指数和胎次对妊娠糖尿病发病的影响

The effect of pre-pregnancy BMI and parity on gestational diabetes mellitus among pregnant women

目的：探讨妊娠前体质指数（body mass index,BMI）、胎次与妊娠糖尿病（gestational diabetes m e l l i t u s,G D M）发病的关系,并探讨其对妊娠糖尿病（G D M）发病的影响。方法：本研究选择我院2014年2月至2014年12月接受孕产期检查、临床资料完整的且患有妊娠糖尿病的孕妇262名,对其采取葡萄糖耐量实验（OGTT实验）,按照WTO标准,对262例足月妊娠初产妇女在孕24~28周常规进行75 g口服糖耐量试验,并完整记录年龄、孕周、文化程度、妊娠前体质指数及胎次等临床资料。根据妊娠前体质指数（BMI）将孕妇分为BMI分为4组,BMI〈18.5 kg/m2者为偏瘦组,BMI18.5~23.0 kg/m2者为正常体质量组,BMI 23.1~25.0 kg/m2者为超重组,BMI〉25.0 kg/m2为肥胖组,采用SPSS l8.0统计软件对资料进行描述性分析、两样本t检验、非条件Logistic回归分析两组孕妇妊娠前体质指数（BMI）、胎次与妊娠糖尿病的关系。结果：4组OGTT结果显示妊娠前超重或肥胖的孕妇发生妊娠糖尿病的风险高于正常和偏瘦体质量组;非条件logistic回归分析结果表明,影响G D M的因素依次为：胎次、体质指数、年龄、文化程度,各影响因素回归系数分别为：2.3 7 2、1.075、0.516、-0.209显示体质指数和胎次是孕妇患妊娠糖尿病的主要危险因素。结论：妊娠前超重及肥胖妇女妊娠胎次越多发生妊娠糖尿病的风险越高。

Object： To investigate relationship of the body mass index（BMI） before pregnancy, parity, with the pathogenesis of gestational diabetes mellitus（GDM）. Methods： A total of 262 cases of patients with GDM who received treatment in the nutrition outpatient department from February 2014 to December 2014 were enrolled in this study, they taked up glucose tolerance test（OGTT）, in accordance with WTO standards. The 262 cases of fullterm pregnancy primiparous women in pregnancy between 24 and 28 weeks were given normal 75 g oral glucose tolerance test, and recorded the clinical data, such as age, gestational age, educational level, pregnancy of body massindex（BMI） and parity. According to the points of body mass index（BMI） before pregnancy, they were divided into 4 groups： BMI 18.5 kg/m2 for underweight group; BMI 18.5~23.0 kg/m2 into normal weight group; BMI 23.1~25.0 kg/m2 for overweight group; BMI 25.0 kg/m2 for obesity group. SPSS l8.0 statistical software of data was used to do descriptive analysis, two sample t test and non-conditional logistic regression analysis, analyzing the relationship among pre-pregnancy body mass index（BMI）, parity and gestational diabetes. Results： A total of 4 groups of OGTT results showed that pregnancy overweight or obese pregnant women pregnancy risk of diabetes is higher than that of normal and lean body mass group; non-conditional logistic regression analysis showed that, the factors affected by GDM followed by： parity, body mass index, age, culture degree. The influence factors of regression coefficients were： 2.372, 1.075, 0.516,-0.209, which displays that body mass index and parity were two major risk factors for pregnant women suffer from gestational diabetes. Conclusion： Pre-pregnancy overweight or obese pregnant women who had more parity are at a higher risk of gestational diabetes mellitus in pregnancy.