生育间隔与妊娠糖尿病间的关系研究

THE STUDY OF ASSOCIATION BETWEEN INTERPREGNANCY INTERVAL AND GESTATIONAL DIABETES MELLITUS

目的探讨孕妇生育间隔与妊娠糖尿病(GDM)间的关系,为GDM的预防控制提供科学依据。方法采用病例对照研究设计,于2018年4月至2020年10月在安徽省妇幼保健院和江西省吉安市妇幼保健院对参加产检的孕妇进行问卷调查。GDM的诊断依据口服葡萄糖耐量试验(OGTT)结果,孕妇生育间隔及相关信息通过自制的调查问卷进行收集。采用多元Logistic回归分析检测生育间隔与GDM间的关系。结果共纳入再生育妇女165人,其中GDM患者63人,对照组102人。病例组孕妇生育间隔平均为56.18月,对照组孕妇平均为35.78月,差异有统计学意义(P<0.001)。多元Logistic回归分析显示,在调整了年龄、民族、文化程度、糖尿病家族史、OGTT检查时孕周、吸烟、饮酒和孕前BMI后,与生育间隔为18~59月的孕妇相比较,生育间隔≥60月的孕妇发生GDM的风险上升156%,差异有统计学意义(P=0.037);生育间隔<18月的孕妇发生GDM风险增加76%,但差异无统计学意义(P=0.462)。按年龄或孕前BMI分组进行敏感性分析,结果显示,在调整了年龄、民族、文化程度、糖尿病家族史、OGTT检查时孕周、吸烟、饮酒和孕前BMI后,各亚组中与生育间隔为18~59月的孕妇相比较,生育间隔≥60月的孕妇发生GDM的风险均显著上升,差异均有统计学意义(均P<0.05)。结论生育间隔与GDM发病风险密切相关,生育间隔过长的孕妇发生GDM的风险显著上升。

Objective:To investigate the relationship between interpregnancy interval and gestational diabetes mellitus(GDM),and to provide scientific basis for the prevention and control of GDM.Method:A case-control study was conducted in Anhui Province Maternity and Child Health Hospital and Ji'an Women and Children Health Hospital of Jiangxi Province from April 2018 to October 2020.The diagnosis of GDM was based on the results of oral glucose tolerance test(OGTT),interpregnancy interval and related information of pregnant women were collected through a self-made questionnaire.Multivariate Logistic regression analysis was used to detect the relationship between interpregnancy interval and GDM.Results:A total of 165 pregnant women were enrolled,including 63 GDM patients and 102 women with control group.The average interpregnancy interval was 56.18 months in the case group and 35.78 months in the control group,the difference was statistically significant(P<0.001).Multivariate Logistic regression analysis showed that after adjusting for a series of potential confounding factors,the risk of GDM in pregnant women with interpregnancy interval≥60 months increased by 156%compared with those with interpregnancy interval of 18-59 months,and the difference was statistically significant(P=0.037).Pregnant women with interpregnancy interval<18 months had an increased risk of GDM,but there was no statistical significance(P=0.462).Sensitivity analysis that subgroup by age or pre-pregnancy BMI showed that,after adjusting for a series of potential confounding factors,the risk of GDM in pregnant women with interpregnancy interval≥60 months was significantly increased in all subgroups compared with pregnant women with interpregnancy interval between 18 and 59 months,with statistical significance(all P<0.05).Conclusion:Interpregnancy interval was closely related to the risk of GDM,and the risk of GDM in pregnant women with longer interpregnancy interval was significantly increased.