妊娠期糖尿病患者的相关因素和妊娠并发症及新生儿情况分析

Analysis on the Related Factors in Patients with Gestational Diabetes Mellitus as well as Pregnancy Complications and Neonatal Conditions

目的探讨妊娠期糖尿病患者的影响因素和妊娠并发症及新生儿情况,为临床的预防与治疗提供参考。方法采用病例对照和队列研究,从2023年6月5日开始到2023年10月28日结束。纳入2019年1月1日至2023年5月31日因分娩在某院产科住院的妊娠期糖尿病(GDM)患者582例作为病例组,另随机抽取同期住院的非妊娠期糖尿病(非GDM)患者582例作为对照组。比较两组年龄、孕前体重指数(BMI)、妊娠次数及妊娠期高血压、羊水异常、新生儿感染、新生儿高胆红素血症发生率等指标。采用t检验,卡方检验,Logistic回归等进行统计学分析。结果⑴GDM组年龄、孕前BMI、妊娠次数均高于对照组(P<0.05);⑵GDM组糖尿病家族史、妊娠期高血压、先兆子痫、妊娠期亚临床甲状腺功能减退发生率均高于非GDM组(P<0.05);⑶GDM组羊水过多、羊水污染、早产、新生儿感染、新生儿高胆红素血症患者数均高于对照组(P<0.05);⑷Logistic回归分析显示,年龄增加、BMI上升、妊娠期高血压、妊娠期亚临床甲状腺功能减退是GDM的危险因素。结论超重、肥胖、糖尿病家族史等都是GDM的高危因素,如果GDM患者血糖控制不佳,将会导致巨大儿、早产、新生儿感染、新生儿高胆红素血症等不良妊娠并发症及新生儿情况,应加强妊娠前健康教育和宣传,孕期定期监测血糖,合理控制血糖是十分必要。

Objectives To explore the influencing factors in patients with gestational diabetes mellitus as well as pregnancy complications and neonatal conditions,and provide reference for clinical prevention and treatment.Methods The case-control and cohort study began on June 5th,2023 and ended on October 28th,2023.A total of 582 patients with gestational diabetes mellitus(GDM)who were hospitalized in the obstetrics department of a hospital due to childbirth from January 1st,2019 to May 31st,2023 were included as the case group,and 582patients with non-gestational diabetes mellitus(non-GDM)who were hospitalized during the same period were randomly selected as the control group.Age,pre-pregnancy body mass index(BMI),pregnancy frequency,pregnancy hypertension,abnormal amniotic fluid,neonatal infection and neonatal hyperbilirubinemia were compared between the two groups.t test,Chi-square test and Logistic regression were used for statistical analysis.Results(1)The age,BMI before pregnancy and times of pregnancy in GDM group were higher than those in control group(P<0.05);(2)The incidence rate of patients with family history of diabetes,hypertension during pregnancy,preeclampsia and subclinical hypothyroidism during pregnancy in GDM group was higher than that in non-GDM Group(P<0.05);(3)The number of patients with excess amniotic fluid,amniotic fluid pollution,premature delivery,neonatal infection and neonatal hyperbilirubinemia in GDM group was higher than that in control group(P<0.05);(4)Logistic regression analysis showed that age,BMI,hypertension during pregnancy and subclinical hypothyroidism during pregnancy were the risk factors of GDM.Conclusions Overweight,obesity and family history of diabetes mellitus were high risk factors of GDM,poor glycemic control in GDM patients could lead to macrosomia,preterm birth,neonatal infection,neonatal hyperbilirubinemia and other adverse pregnancy outcomes,so it was necessary to strengthen health education and propaganda before pregnancy,to monitor blood glucose regularly during pregnancy and control blood glucose reasonably.