妊娠期糖尿病患者母婴结局现状及影响因素

Status quo of maternal and infant outcomes in gestational diabetes mellitus and the influencing factors

目的 调查妊娠期糖尿病患者母婴结局的现状并分析其影响因素,为促进母婴健康提供参考依据。方法 以2020年1月-2021年12月在北京大学第一医院宁夏妇女儿童医院定期产检并分娩的752例妊娠期糖尿病患者为研究对象,收集患者的临床资料,采用单因素和多因素Logistic回归分析影响妊娠期糖尿病患者母婴结局的因素。结果 752例妊娠期糖尿病患者中,母婴不良结局的发生率为70.88%,多因素Logistic回归分析结果显示,孕期体质量增长>14 kg、分娩时孕期<37周或>40周、孕前BMI增大(超重OR=2.466,95%CI:1.269~4.775、肥胖OR=26.968,95%CI:5.948~122.505)是妊娠期糖尿病患者母婴不良结局发生的独立危险因素(P<0.05)。结论 银川市妊娠期糖尿病患者母婴不良结局总发生率较高,防治形式不容乐观;孕期体质量增长>14 kg、分娩时孕周不正常、孕前BMI高是影响妊娠期糖尿病患者母婴不良结局的重要因素。

Objective To investigate the current status of maternal and infant outcomes in patients with gestational diabetes mellitus and analyse the infl uencing factors,to provide a reference basis for the promotion of maternal and infant health.Methods 752 patients with gestational diabetes mellitus who underwent regular obstetric examination and delivered at Ningxia Women's and Children's Hospital of Peking University First Hospital from January 2020 to December 2021 were selected as the study subjects,and the clinical data of the patients were collected,and the factors affecting maternal and infant outcomes of patients with gestational diabetes mellitus were analysed by using univariate and multivariate logistic regression.Results The incidence of adverse maternal and infant outcomes was 70.88%in 752 patients with gestational diabetes mellitus,and the results of multifactorial Logistic regression showed that an increase in body mass of>14 kg during pregnancy,a delivery gestation of<37 or>40 weeks,and an increase in pre-pregnancy BMI(overweight OR=2.466,95%CI:1.269~4.775,obesity OR=26.968,95%CI:5.948~122.78,and obesity OR=5.948~123.968,95%CI:5.948~122.968,95%CI:5.948~122.505)were independent risk factors for the occurrence of adverse maternal and infant outcomes in patients with gestational diabetes mellitus(P<0.05).Conclusion The overall incidence of adverse maternal and infant outcomes in patients with gestational diabetes mellitus in Yinchuan was high,and the prevention and treatment are not optimistic;body mass increase of>14 kg during pregnancy,abnormal gestational week of delivery,and high pre-pregnancy BMI are important factors affecting adverse maternal and infant outcomes in patients with gestational diabetes mellitus.