妊娠期糖尿病影响因素分析

Analysis of influencing factors of gestational diabetes mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)影响因素,为针对性防治提供理论依据。方法选取2013年11月至2017年6月临沂市中心医院围产期保健的1 018例孕妇进行研究,并按是否患GDM分为病例组(302例)与对照组(716例),采用χ2检验与多因素Logistic回归分析对GDM影响因素进行分析。结果 1 018例孕妇中,检测出GDM患者302例,患病率为29.67%。单因素分析提示两组孕妇在年龄、孕前体质量指数(body mass index,BMI)、人均月收入、孕前运动、睡眠质量、被动吸烟、文化程度、糖尿病家族史、喜爱甜食、月经周期紊乱、孕期增重等因素方面差异有统计学意义(P<0.05);不同孕次比较差异无统计学意义(P>0.05)。将差异有统计学意义的因素赋值,代入多因素Logistic回归分析,结果发现年龄≥35岁、孕前BMI≥24 kg/m^2、人均月收入<4 000元、被动吸烟、文化程度初中及以下、糖尿病家族史、喜爱甜食、月经周期紊乱、孕期增重≥25 kg为GDM发生的危险因素(P<0.05),而孕前运动及睡眠质量好是保护因素(P<0.05)。结论 GDM的发生与年龄≥35岁、孕前BMI≥24 kg/m^2、人均月收入<4 000元、被动吸烟、文化程度初中及以下、糖尿病家族史、喜爱甜食、月经周期紊乱、孕期增重≥25 kg等因素有关,而孕前运动与睡眠质量好有利于预防GDM。

Objective To investigate the influencing factors of gestational diabetes mellitus（ GDM）,and provide evidence for prevention. Methods 1 018 cases of pregnant women in Central Hospital of Linyi City from October 2013 to June 2017 were chosen,and according to whether GDM divided into case group（ 302 cases） and control group（ 716 cases）. χ^2 test and multivariate logistic regression analysis were used to analyze the influencing factors of GDM. Results 302 cases with GDM were found in 1 018 cases of pregnant women,the prevalence rate was 29. 67 %. Single factor analysis showed that age,pre pregnancy BMI,per capita monthly income,pre pregnancy exercise,sleep quality,passive smoking,educational level,family history of diabetes,sweets,menstrual cycle disorder and weight gain during pregnancy between two groups had significant difference（ P〈0. 05）. Times of pregnany between two groups had no significant difference（ P〉0. 05）. The factors with statistically significant differences were assigned to multivariate logistic regression analysis,the results showed that age≥35,pre pregnancy BMI≥24 kg/m^2,per capita monthly income〈 4 000 yuan,passive smoking,educational level under junior middle school,family history of diabetes,sweets,menstrual cycle disorder and weight gain during pregnancy≥25 kg were the risk factors of GDM. Pre pregnancy exercise,good sleep quality were the protective factors（ P〈0. 05）. Conclusion Age ≥ 35,pre pregnancy BMI ≥ 24 kg/m^2,per capita monthly income 4 000 yuan,passive smoking,educational level under junior middle school,family history of diabetes,sweets,menstrual cycle disorder and weight gain during pregnancy≥25 kg are the risk factors of GDM,pre pregnancy exercise,good sleep quality are the protective factors.