高龄GDM孕妇母婴结局及风险因素分析

Analysis of the maternal infant outcomes and the risk factors of advanced pregnant women with gestational diabetes mellitus

目的:分析高龄妊娠期糖尿病(GDM)孕妇母婴结局及风险因素。方法:选取2019年6月-2023年6月本院收治的183例GDM高龄孕妇为GDM组,健康高龄孕妇150例为对照组,比较两组母婴结局;采用logistic多因素回归分析GDM发生的风险因素。结果:GDM组剖宫产(53.0%)、羊水过多(10.4%)、子痫前期(18.6%)、产后出血(9.3%)、妊娠期高血压(13.1%)发生率均高于对照组(38.7%、3.3%、6.7%、1.3%、2.7%),早产儿(9.29%)、巨大儿(9.8%)、新生儿窒息(10.4%)、胎儿窘迫(19.1%)率均高于对照组(2.0%、3.3%、4.0%、7.3%)(均P<0.05)。多因素分析显示,孕前体质指数(BMI)≥24kg/m^(2)、日常运动量<2h/d、糖尿病家族史是高龄孕妇GDM发病的独立危险因素,文化程度高是保护因素(均P<0.05)。结论:高龄GDM孕妇会增加母婴不良结局风险,且发病与孕前BMI高、日常运动量少、糖尿病家族史密切相关,临床应予以关注并采取干预措施,以改善母婴结局。

Objective:To analyze the maternal-infant outcomes and the risk factors of advanced pregnant women with gestational diabetes mellitus(GDM).Methods:A total of 183 advanced pregnant women with GDM admitted to hospi-tal from June 2019 to June 2023 were selected in study group.Meanwhile,150 healthy advanced pregnant women were selected in the control group.The maternal-infant outcomes of the women were compared between the two groups.Multivariate logistic regression analysis was conducted to analyze the risk factors of GDM occurrence of the women.Results:The incidences of the cesarean section(53.0%),the polyhydramnios(10.4%),the preeclampsia(18.6%),the postpartum hemorrhage(9.3%)and the gestational hypertension(13.1%)of the women in the study group were significantly higher than those(38.7%,3.3%,6.7%,1.3%and 2.7%)of the women in the control group.The rates of the premature birth(9.3%),the macrosomia(9.8%),the neonatal asphyxia(10.4%)and the fetal distress(19.1%)in the study group were also significantly higher than those(2.0%,3.3%,4.0%and 7.3%)in the control group(all P<0.05).Multivariate analysis showed that the pre-pregnancy body mass index(BMI)≥24kg/m^(2),the daily exercise time<2h/day and the family history of diabetes of the advanced pregnant women were the independent risk factors of their GDM occurrence,and the high education level of the advanced pregnant women was a protective factor of their GDM occurrence(all P<0.05).Conclusion:The advanced pregnant women with GDM will increase the.risk of their adverse maternal infant outcomes,and their GDM occurrence is closely related to the higher prepregnancy BMI,the less daily exercise and the family history of diabetes of the women,so which should be paid attention to and the corresponding intervention measures should be taken to the women for improving their maternal and infant out-comes in clinic.