妊娠期糖尿病的危险因素及妊娠结局分析——基于1888例孕妇的队列研究

The analysis of risk factors and pregnancy outcome of gestational diabetes mellitus-a cohort study based on 1888 cases of pregnant women

目的探讨孕妇发生妊娠期糖尿病(GDM)的危险因素及其对妊娠结局的影响。方法选择2019年8月至2020年7月在宁波市妇幼保健信息平台登记,并在镇海区及鄞州区江东妇幼保健院建卡的1888名孕妇作为研究对象。根据GDM发病与否分为GDM组和健康对照组,收集两组的年龄、职业、文化程度、月经史、生育史、唐氏筛查结果、生活习惯、饮食、家族史等资料,进行多因素非条件Logistic回归分析,并分析其与妊娠结局的相关性。结果1888例孕妇中GDM患者66例,发病率为3.5%。多因素Logistic回归分析显示,职业、胎盘生长因子(PLGF)、唐氏筛查风险分级均为GDM的危险因素(P<0.05)。GDM组巨大儿的发生率为11.3%,高于对照组(P<0.05)。结论针对GDM发病的危险因素采取预防措施,可以降低GDM的罹患率、改善母婴结局。

Objective To investigate the risk factors of gestational diabetes mellitus(GDM)and its influence on pregnancy outcome.Methods A total of 1888 pregnant women registered in Ningbo Maternal Child Information System,and antenatal examination in Zhenhai District and Yinzhou District Jiangdong Maternal and Child Health Care Hospital from August 2019 to July 2020 were selected as the research subjects.The pregnant women were divided into the GDM group and control group according to whether diagnosed with GDM or not.The data including age,occupation,education levels,menstrual history,family history,Down's syndrome screening results,life habits,diet,placental growth factor(PLGF)and pregnancy outcomes of two groups were collected.The multivariate unconditional Logistic regression was used to analyze the risk factors of GDM,and to analyze the correlation with pregnancy outcomes.Results Among the 1888 pregnant women,66 women were diagnosed with GDM,the incidence of GDM is 3.50%.Multivariate logistic regression analysis showed that occupation,PLGF and Down's syndrome screening results were risk factors for GDM(P<0.05).In the GDM group,the incidence of macrosomia was 11.3%,higher than healthy pregnant(P<0.05).Conclusion The pathogenesis of GDM is closely related to occupation,PLGF and Down's syndrome screening results.GDM increase the incidence of macrosomia.Preventive measures should be taken targeting at the risk factors so as to reduce the incidence of GDM and improve maternal and infant health outcomes.