廊坊市妊娠期糖尿病孕妇发生不良妊娠结局现况与影响因素分析

Status and influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus in Langfang City

目的 探讨妊娠期糖尿病孕妇发生不良妊娠结局现状及其影响因素。方法 以2018年6月至2022年11月在河北中石油中心医院及廊坊广安医院建立产前健康档案并在该医院分娩的妊娠期糖尿病孕妇为调查对象,随访至孕妇分娩结束,对不良妊娠结局的孕妇和正常妊娠结局的孕妇相关资料进行比较分析,并采用多因素logistic回归模型分析妊娠期糖尿病孕妇发生不良妊娠结局的影响因素。结果 共纳入2 027例妊娠期糖尿病孕妇,出现羊水过多86例、产后出血94例、胎膜早破98例、早产108例、巨大儿101例、新生儿低血糖86例、低出生体重92例、新生儿窒息86例,不良妊娠结局发生率为37.05%(751/2 027)。多因素logistic回归分析结果显示,妊娠期糖尿病孕妇发生不良妊娠结局的影响因素包括年龄≥35岁(OR=3.618)、孕期增重不适宜(OR=3.762)、有糖尿病家族史(OR=2.246)、不良孕产史(OR=2.807)、3项OGTT血糖异常(OR=3.662)、血清胰高血糖素样肽1(GLP-1)水平低(OR=2.408)、单核细胞趋化蛋白-1(MCP-1)水平高(OR=1.489)、血清组织蛋白酶S(Cat S)水平高(OR=2.482)。结论 妊娠期糖尿病孕妇不良妊娠结局发生率较高。妊娠期糖尿病孕妇不良妊娠结局的影响因素包括高龄、孕期增重不适宜、有糖尿病家族史、不良孕产史、3项OGTT血糖异常等,为降低不良妊娠结局的发生风险应对妊娠期糖尿病孕妇进行有针对性的干预及治疗。

Objective To explore the status and influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus.Methods The pregnant women with gestational diabetes mellitus who estab-lished prenatal health records and gave birth in Hebei China Petroleum Central Hospital and Langfang Guang'an Hospital from June 2018 to November 2022 were taken as the subjects of the survey,and were followed up to the end of the delivery.The related data of pregnant women with adverse pregnancy outcomes and pregnant women with normal pregnancy out-comes were compared and analyzed,and multivariate logistic regression model was used to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus.Results A total of 2027 pregnant women with gestational diabetes mellitus were included,including 86 cases of polyhydramnios,94 cases of postpartum hemorrhage,98 cases of premature rupture of membranes,108 cases of premature delivery,101 cases of macrosomia,86 cases of neonatal hypoglycemia,92 cases of low birth weight,and 86 cases of neonatal asphyxia.The incidence of adverse pregnancy outcomes was 37.05%(751/2027).Multivariate logistic regression analysis showed that the influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus included age≥35 years(OR=3.618),inappropriate weight gain during pregnancy(OR=3.762),family history of diabetes(OR=2.246),adverse pregnancy and childbirth history(OR=2.807),three OGTT blood glucose abnormalities(OR=3.662),low serum level of glucagon like peptide 1(CLP-1)(OR=2.408),high level of monocyte chemoattractant protein-1(MCP-1)(OR=1.489),and high serum level of cathepsin S(Cat S)(OR=2.482).Conclusions The incidence of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus is high.The influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus include old age,inappropriate weight gain during pregnancy,family history of diabetes,adverse pregnancy and childbirth history,and three OGTT blood glucose abnormalities,et al.In order to reduce the risk of adverse pregnancy outcomes,targeted intervention and treatment should be carried out for pregnant women with gestational diabetes mellitus.