妊娠中期孕妇糖代谢水平与早产的相关性

Correlation between glucose metabolism and preterm delivery in second trimester of pregnancy

目的分析妊娠中期孕妇糖代谢水平与早产的相关性。方法回顾性分析,收集2017年1月至2020年12月期间于本院接受正常产检并完成分娩产妇300例临床资料,所有孕妇均在孕中期(24-27+6周)进行葡萄糖耐量试验,检测各项糖代谢指标,查阅孕妇资料发现早产28例(9.33%),统计孕妇妊娠中期检测糖代谢相关指标、并设计基线资料表填写产妇相关资料。分析妊娠中期孕妇糖代谢水平与早产的相关性。结果纳入300例孕妇,早产28例(9.33%),足月生产272例(96.67%);早产组FBG、2hPBG、HbA1c、FINS、HOMA-IR均高于非早产组,HOMA-β低于非早产组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,血清FBG、2hPBG、HbA1c、FINS、HOMA-β、HOMA-IR异常可能是导致孕妇早产的的影响因素(OR>1,P<0.05);绘制ROC曲线(见图1),结果显示,血清FBG、2hPBG、HbA1c、FINS、HOMA-β、HOMA-I预测孕妇早产的AUC均>0.7,具有较高预测价值,当获得最佳阈值时,可获得最佳预测价值。结论妊娠中期孕妇糖代谢水平异常与早产的发生密切相关,临床可通过妊娠中期检测孕妇血糖代谢相关指标,进行早期防治,以降低早产发生率。

Objective Objective to analyze the correlation between glucose metabolism and preterm delivery in the second trimester of pregnancy.Methods Retrospective analysis,collected from January 2017 to December 2020 in our hospital to receive normal prenatal examination and complete delivery of 300cases of maternal clinical data,all pregnant women in the second trimester(24-27+6weeks)for glucose tolerance test,detection of various glucose metabolism indicators,access to maternal data found 28cases of early birth(9.33%),statistics of pregnant women in the second trimester detection of glucose metabolism related indicators,and design baseline data Fill in the relevant information of puerpera.Objective to analyze the correlation between glucose metabolism and preterm delivery in the second trimester of pregnancy.Results Among 300pregnant women,28cases(9.33%)were preterm,272cases(96.67%)were full-term delivery;FBG,2hpbg,HbA1c,fins,HOMA-IR in preterm group were higher than those in non preterm group,HOMA-βwas lower than that in non preterm group,the difference was statistically significant(P<0.05);logistic regression analysis showed that abnormal serum FBG,2hpbg,HbA1c,fins,HOMA-β,HOMA-IR may be the risk factors of preterm delivery The results showed that the AUC of FBG,2hpbg,HbA1c,fins,HOMA-β and homa-i in predicting premature delivery were all higher than 0.7,which had high predictive value.When the best threshold was obtained,the best predictive value could be obtained.Conclusion The abnormal glucose metabolism level of pregnant women in the second trimester of pregnancy is closely related to the occurrence of preterm birth.We can detect the related indicators of blood glucose metabolism of pregnant women in the second trimester of pregnancy for early prevention and treatment,so as to reduce the incidence of preterm birth.