妊娠期糖尿病筛查及其危险因素分析

Screening of gravidity diabetes mellitus and analysis of its risk factors

目的妊娠期糖尿病(gravidity diabetes mellitus,GDM)是指妊娠期间发生的不同程度的糖代谢异常,但血糖未达到显现水平,可引起早产、巨大儿和胎儿窘迫等不良妊娠结局。本研究分析本地区GDM筛查结果,探讨GDM危险因素。方法按照中华医学会制定的GDM和甲状腺诊断标准,选取2017-01-01-2018-08-31在昆山市淀山湖人民医院妇保门诊建卡并进行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)的583名孕妇为研究对象,孕妇在6~12周进行建卡,测量身高和体质量,检验甲状腺功能等,在24~28周进行OGTT试验。分析孕妇年龄、体质量指数(body mass index,BMI)、亚临床甲减和甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)对GDM影响。结果本次共检测孕妇583名,糖耐量正常(normol glucose tolerance,NGT)535名,GDM 48例,检出率为8.23%;亚临床甲减29例,检出率为4.97%。单因素结果显示,年龄(χ^2=16.52,P<0.001)是GDM危险因素。Logistic回归分析结果显示,年龄>30岁(OR=7.851,95%CI为2.272~27.121,P<0.001)是GDM危险因素。结论本地区GDM检出率较高,当孕妇年龄>30岁,GDM危险性增高,临床产检中应加强高龄孕妇血糖检测力度,保障母婴健康。

OBJECTIVE Gravidity diabetes mellitus(GDM)refers to various degrees of abnormal glucose metabolism during pregnancy,but blood glucose does not reach the level of diabetes mellitus,which can lead to premature birth,macrosomia,fetal distress and other adverse pregnancy outcomes.To analyze the screening results of GDM in this area and explore the risk factors of GDM.METHODS According to the diagnostic criteria for gestational diabetes mellitus and thyroid gland established by the Chinese Medical Association,a total of 583 pregnant women who were enrolled in the oral glucose tolerance test(OGTT)from January 1,2017 to August 31,2018 were selected as the research subjects.Pregnant women were enrolled in the OGTT test at 6-12 weeks,and their height and weight were measured and thyroid function were tested at 24-28 weeks.The effects of maternal age,body mass index(BMI),subclinical hypothyroidism and thyroid peroxidase antibody(TPOAb)on gravidity diabetes mellitus were analyzed.RESULTS A total of 583 pregnant women were detected,535 with normal glucose tolerance(NGT),48 with GDM,and the detection rate of GDM was 8.23%.Subclinical hypothyroidism was found in 29 cases,with a detection rate of 4.97%.Univariate results showed that age was a risk factor for GDM,χ^2=16.52,P<0.001.Logistic regression analysis showed that only age was the risk factor for GDM(OR=7.851,95%CI:2.272-27.121,P<0.001).When the age of pregnant women was over 30 years old,the risk of gestational diabetes mellitus increased.CONCLUSIONS The detection rate of GDM in this region is relatively high.When the age of pregnant women is>30 years old,the risk of GDM is increased.In clinical examination,the blood sugar test of pregnant women should be strengthened to ensure maternal and child health.