妊娠期糖尿病发病的危险因素分析

Analyse the risk factors related to gestational diabetes mellitus

目的:探讨妊娠期糖尿病(gestational diabetes mellitus, GDM)发病的危险因素,为预防GDM的发生提供临床依据。方法:回顾性分析2016年1—12月妇女保健科收治的GDM患者162例(观察组),按1∶1比例收集同期在我院妇女保健科产检的162例正常孕妇作为对照组。自制调查问卷调查受试者的年龄、孕前体质量指数(body mass index,BMI)、月收入、文化程度、胎次、糖尿病家族史、膳食模式等相关影响因素,分析GDM的危险因素。结果:单因素分析发现年龄、孕前BMI、文化程度、胎次、糖尿病家族史、孕期并发症、膳食、负性情绪与GDM发病相关,进一步行多因素非条件Logistic回归分析,结果显示孕前BMI、多胎次、糖尿病家族史、高能量摄食、高碳水化合物比例摄食是GDM的危险因素,OR值分别为4.25(2.98～4.53)、4.06(2.77～4.28)、2.01(1.98～3.04)、3.21(2.25～3.96)、5.01(4.06～5.95),差异均有统计学意义(均P<0.05)。结论:妊娠期肥胖、多胎次、糖尿病家族史、高能量摄食、高碳水化合物比例摄食是GDM的危险因素,单纯高蛋白质比例膳食与其发病无关。

Objective： To explore the risk factors for gestational diabetes mellitus（GDM）,aimed to provide clinical basis for the prevention of GDM. Methods： A retrospective analysis of 162 patients with GDM admitted to Department of Women Health Care from January to December in 2016 were conducted（observation group）. While 162 normal pregnant women（con- trol group） in our department during the same time were collected in 1：1 ratio. The self-made questionnaires were used to survey the related influence factors such as the age, body mass index（BMI）, monthly income, educational level, parity, family history of diabetes mellitus, diet pattern and so on. The risk factors for GDM were analyzed. Results： The univariate analysis revealed that the age, BMI pre-pregnancy, educational level, parity, family history of diabetes mellitus, pregnancy complica- tions, diet and negative emotion were associated with GDM. Unconditional multiple Logistic regression showed that the BMI pre-pregnancy, multiple parity, family history of diabetes mellitus, high energy diet, and high carbohydrate diet were the risk factors for GDM[OR value was 4.25（2.98-4.53）, 4.06（2.77-4.28）, 2.01（1.98-3.04）, 3.21（2.25-3.96） and 5.01 （4.06-5.95） re- spectively], the difference was statistically significant（all P〈0.05）. Conclusion： The obesity during pregnancy, multiple parity, family history of diabetes mellitus, high energy and high carbohydrate diet are the risk factors for GDM. The simple high pro- tein diet is unrelated to the onset of diabetes.