合并妊娠糖尿病的高龄孕产妇并发妊娠高血压疾病危险因素分析

Risk factors of gestational diabetes mellitus complicated with hypertensive disorder complicating pregnancy in elderly pregnant women

目的探讨合并妊娠糖尿病(gestational diabetes mellitus,GDM)的高龄孕产妇并发妊娠高血压疾病(hypertensive disorder complicating pregnancy,HDCP)的危险因素。方法选取2016年1月至2018年6月于本院诊治的107例GDM并发HDCP的高龄孕产妇纳入观察组,并选取同期于本院诊治的150例仅合并GDM的高龄孕产妇纳入对照组,比较两组孕产妇的临床资料,采用多因素Logistic回归分析探讨合并GDM的高龄孕产妇并发HDCP的独立危险因素。结果观察组中有吸烟史、孕前肥胖、多胎妊娠、有高血压家族史、口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)的3项均异常、有低钙血症、焦虑、抑郁的高龄孕产妇占比均显著高于对照组(P_均<0.05)。多因素Logistic回归分析表明:孕前肥胖(OR=3.166,95%CI:1.186～8.452)、OGTT的3项均异常(OR=3.330,95%CI:1.131～9.805)、抑郁(OR=4.633,95%CI:1.332～16.115)均为合并GDM的高龄孕产妇并发HDCP的独立危险因素(P_均<0.05)。结论对于合并GDM的高龄孕产妇而言,孕前肥胖、OGTT的3项均异常、抑郁均为其并发HDCP的独立危险因素,临床上应针对高危因素者给予重点防控。

Objective To analyze the risk factors of gestational diabetes mellitus(GDM)complicated with hypertensive disorder complicating pregnancy(HDCP)in elderly pregnant women.Method 107 elderly pregnant women with GDM complicated with HDCP were enrolled for the study as observation group,and 150 elderly pregnant women with GDM but without HDCP were selected as control group.The clinical data were compared between the two groups,and multivariate Logistic regression analysis was performed to screen out the independent influencing factors of HDCP.Result The proportion of smoking history,obesity before pregnancy,multiple pregnancy,family history of hypertension,3 abnormal indexes of oral glucose tolerance test(OGTT),hypocalcemia,anxiety and depression in observation group were significantly higher than those in control group(Pall<0.05).Multivariate Logistic regression analysis showed that obesity before pregnancy(OR=3.166,95%CI:1.186~8.452),3 abnormal indexes of OGTT(OR=3.330,95%CI:1.131~9.805)and depression(OR=4.633,95%CI:1.332~16.115)were the independent risk factors for HDCP in elderly pregnant women with GDM(Pall<0.05).Conclusion For elderly pregnant women with GDM,obesity before pregnancy,3 abnormal indexes of OGTT and depression are the independent risk factors for HDCP,which need to be focused on clinical prevention and control.