Advanced glycation end-products change placental barrier function and tight junction in rats with gestational diabetes mellitus via the receptor for advanced glycation end products/nuclear factor-κB pathway

The placenta plays an important role in nutrient transport to maintain the growth and development of the embryo.Gestational diabetes mellitus(GDM),the most common complication during pregnancy,highly affects placental function in late gestation.Advanced glycation end-products(AGEs),a complex and heterogeneous group of compounds engaged by the receptor for AGEs(RAGE),are closely associated with diabetes-related complications.In this study,AGEs induced a decrease in the expression of tight junction(TJ)proteins in BeWo cells and increased the paracellular permeability of trophoblast cells by regulating RAGE/NF-κB.Sprague-Dawley(SD)rats injected with 100 mg/kg AGEs-rat serum albumin(RSA)via the tail vein from embryo day 2 were set as the placental barrier dysfunction model group(n=10).The effect of AGEs on placental permeability was determined using the Evans-Blue dye extravasation method.The ultrastructure of the placenta samples was observed by transmission electron microscopy.The effects of AGEs on the placenta were confirmed by treating rats with RAGE antagonist FPS-ZM1 and soluble forms of RAGE(sRAGE).AGEs treatment increased placental permeability and disrupted the tight junctions in pregnant rat placenta,but has no effect on blood glucose.The expression of TJ-related proteins,including ZO-1,Occludin,and Claudin 5,were downregulated after AGEs treatment.Further,AGEs treatment increased the expression of RAGE and nuclear factor-κB in the placenta of rats and upregulated the levels of vascular endothelial growth factor.The effects of AGEs on the placenta were blocked by RAGE antagonist FPS-ZM1 and sRAGE.This study demonstrates the mechanism underlying AGEs-induced disturbance in placental function in pregnant rats and highlights the potential of AGEs in the treatment of GDM.

Association between plasma dipeptidyl peptidase-4 levels and cognitive function in perinatal pregnant women with gestational diabetes mellitus

BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.

Pregnant Women with Diabetes under the Novel COVID-19 Pneumonia Epidemic Home Protection and Diet and Exercise Management

Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patients during pregnancy may have a variety of complications, which can have a serious adverse impact on their own and fetal health. This article elaborates on home protection and diet and exercise guidance for pregnant women with diabetes in order to provide guidance for pregnant women with diabetes in a special period, and further prevent and control the pneumonia epidemic caused by novel COVID-19 infection in pregnant women.

Association between Vitamin D Insufficiency and the Risk for Gestational Diabetes Mellitus in Pregnant Chinese Women

Objective To investigate the association between vitamin D deficiency and risk of gestational diabetes rnellitus （GDM） in pregnant Chinese women. Methods A nested case-control study was conducted. Clinical and biochemical data were analyzed for 200 subjects with GDM and 200 subjects with normal glucose tolerance （NGT）. Results The median （interquartile range） serum 25-hydroxyvitamin D （25OHD） levels were 22.39 （17.67, 29.38） and 25.86 （19.09, 34.88） nmol/L in the GDM and NGT groups, respectively. Rates of 25OHD deficiency or insufficiency were significantly higher in the GDM group than in the NGT group. Subjects with 25OHD levels 〈25 nmol/L had a 1.g-fold higher risk of GDM compared with subjects with higher vitamin D levels. In the GDM group, serum 25OHD was independently associated with HbAlc and insulin resistance after adjusting for confounding factors. In the NGT group, serum 25OHD was independently associated with fasting plasma glucose and systolic blood pressure after adjusting for maternal age and other confounding factors. Conclusion 2SOHD insufficiency is very common in Chinese women. Low 25OHD status may be associated with insulin resistance and act as a risk factor for GDM.

Genetic association of rs7754840 and rs7756992 polymorphisms in the CDKAL1 gene and gestational diabetes mellitus in selected Filipino pregnant women

Objective:To investigate the possible association between rs7754840 and rs7756992 polymorphisms of CDKAL1 gene and susceptibility to gestational diabetes mellitus(GDM)in a Filipino pregnant population.Methods:A total of 101 patients with GDM and 99 women without GDM were included.Two CDKAL1 gene single nucleotide polymorphisms(SNPs),namely rs7754840 and rs7756992,were genotyped by using TaqMan allelic discrimination assays.Mann-Whitney U test,median and interquartile range were used to describe physical and biochemical characteristics.The differences in the genotype and allele distribution of the target genetic variants among the two groups of participants were assessed by using Chi-square test.Conformity to Hardy-Weinberg equilibrium was tested prior to conducting further analysis.Multiple logistic regression model was used to investigate the effects of the genotype models on GDM development.Results:There was no observed correlation between the genotypes of the rs7754840 SNP and oral glucose tolerance test parameters.Consequently,there was no significant association between genetic models of the rs7754840 SNP and GDM risk(additive OR 1.43,95%CI 0.82-2.50,P=0.21;dominant OR 1.21,95%CI 0.57-2.59,P=0.62;recessive OR 1.63,95%CI 0.86-3.09,P=0.13).Conclusions:The results of this study suggest no association between CDKAL1 gene variant rs7754840 and GDM development in Filipino pregnant women.Further studies with a larger population should be performed to validate our findings.

Association of Dietary Pattern during Pregnancy and Gestational Diabetes Mellitus： A Prospective Cohort Study in Northern China

Objective To examine the association of maternal dietary patterns during pregnancy with gestationa diabetes mellitus （GDM） in northern China. Methods The dietary intakes of pregnant women were recorded twice by 24-hour dietary recalls for three days prior to having been diagnosed with GDM, at 5-15 and 24-28 gestational weeks, respectively. GDM was diagnosed, and serum glycosylated hemoglobin （HbAlc） was measured at 24-28 weeks. Dietary patterns were assessed by factor analysis. The association of the dietary pattern with GDM and HbAlc was examined by multiple logistic models. Results Of 753 participants, 64 （8.5%） were diagnosed with GDM. Four dietary patterns were identified： Western pattern （dairy, baked/fried food and white meat）, traditional pattern （light-colored vegetables, fine grain, red meat and tubers）, mixed pattern （edible fungi, shrimp/shellfish and red meat） and prudent pattern （dark-colored vegetables and deep-sea fish）. Compared with the prudent pattern, both the Western pattern and the traditional pattern were associated with an increased risk of GDM （aOR = 4.40, 95% CI： 1.58-12.22; aOR = 4.88, 95% Ch 1.79-13.32） and a high level of HbAlc （aOR = 12.37, 95% Ch 1.47-103.91; aOR = 26.23, 95% CI： 2.54-270.74）. Compared to the lowest quartile （Q）, 0.3 of the Western pattern scores and Q3-Q4 of the traditional pattern scores were associated with a higher risk of GDM. Conclusion The consumption of the Western pattern or the traditional pattern during pregnancy may increase the risk of GDM.

基于互联网平台的5A护理模式在妊娠糖尿病患者中的应用效果

目的探究基于互联网平台的5A护理模式在妊娠糖尿病(GDM)患者中的应用效果。方法选取2019年7月至2022年2月在滨州市中心医院进行产检的115例GDM患者进行前瞻性研究,采用随机数字表法将其分为对照组和研究组。对照组58例,年龄22~33岁,予以临床常规护理干预;研究组57例,年龄22~35岁,予以常规护理增加基于互联网平台的5A护理模式干预。比较两组患者血糖[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]控制情况、自我效能感[糖尿病管理自我效能量表(DMSES)、一般自我效能感量表(GSES)]、心理状态[妊娠相关焦虑量表(PAQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自我管理能力[改良版糖尿病自我管理行为量表(SDSCA)]及妊娠结局情况。统计学方法采用t检验、χ^(2)检验。结果护理后,研究组FBG、HbA1c水平均低于对照组[(5.11±1.02)mmol/L比(5.62±1.12)mmol/L、(5.21±1.04)%比(5.74±1.15)%],差异均有统计学意义(t=2.55、2.59,均P<0.05);研究组DMSES、GSES评分均高于对照组[(168.47±18.72)分比(154.32±17.15)分、(35.27±3.92)分比(31.48±3.51)分],差异均有统计学意义(t=4.23、5.46,均P<0.05);研究组PAQ、SAS、SDS评分均低于对照组[(18.51±3.70)分比(21.42±4.28)分、(41.32±6.88)分比(45.51±7.58)分、(42.33±7.05)分比(45.62±7.61)分],差异均有统计学意义(t=3.90、3.10、2.40,均P<0.05);研究组SDSCA中饮食、运动、血糖监测、足部护理评分均高于对照组[(22.15±3.69)分比(20.41±3.40)分、(10.87±2.17)分比(9.43±1.89)分、(11.12±2.22)分比(10.21±2.04)分、(11.45±2.29)分比(10.31±2.06)分],差异均有统计学意义(t=2.63、3.80、2.29、2.81,均P<0.05)。研究组羊水过多、巨大儿发生率均低于对照组[5.26%(3/57)比18.97%(11/58)、7.02%(4/57)比24.13%(14/58)],差异均有统计学意义(χ^(2)=5.05、6.38,均P<0.05)。结论对GDM患者应用基于互联网平台的5A护理模式干预,孕期血糖水平得到明显控制,且自我效能感、心理状态及自我管理能力均有改善,有较好妊娠结局。

基于运动饮食血糖控制对高龄产妇妊娠期糖尿病患者妊娠结局的影响及并发症分析

目的评价基于运动饮食血糖控制在高龄产妇妊娠期糖尿病患者中的应用效果。方法选择2019年1月—2022年6月山东省寿光市人民医院收治的140例高龄产妇妊娠期糖尿病患者为研究对象,按随机数表法分成两组(对照组和观察组),对照组70例接受常规孕期保健,观察组70例在对照组基础上接受运动饮食指导,比较两组的血糖水平、不良妊娠结局、新生儿不良结局。结果观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、不良妊娠结局总发生率、新生儿不良结局总发生率均低于对照组,差异有统计学意义(P均<0.05)。结论在高龄产妇妊娠期糖尿病患者中,基于运动饮食血糖控制可有效降低患者血糖水平,且可改善患者妊娠结局以及新生儿结局。

基于信息框架效应的干预方案对妊娠期糖尿病孕妇自我管理行为和负性情绪的影响

目的探讨基于积极信息框架效应教育干预对妊娠期糖尿病孕妇自我管理行为和负性情绪的影响。方法随机抽取福建省立医院2022年8月至2023年4月收治的116例妊娠期糖尿病孕妇作为本次研究对象,依据随机数字表法分为对照组和观察组,分别为56例、60例,对照组采用常规干预,观察组采用积极信息框架的教育干预方案。比较两组自我管理行为、血糖水平及监测情况、分娩结局、负性情绪。结果干预后,观察组饮食、运动、血糖监测、遵医嘱用药等自我管理行为(SDSCA)评分以及定期监测血糖率均较对照组高(均P<0.05);干预后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)等血糖水平、总不良妊娠结局发生率以及负性情绪评分均较对照组低(均P<0.05)。结论信息框架对妊娠期糖尿病孕妇自我管理行为的影响较为积极,有助于改善患者血糖情况,改善心理情况,降低不良分娩结局发生率。

BMI变化对妊娠期糖尿病母婴结局的影响

目的探讨妊娠期糖尿病(GDM)孕妇孕期不同体重指数(BMI)变化与母婴结局的相关性。方法选取百色市人民医院2019至2021年进行产检、分娩并确诊为GDM的孕妇200例作为研究对象,根据体重(BMI)增长幅度(ΔBMI)变化量将其分成ΔBMI<4 kg/m^(2)组(BMI增长不足组,n=51)、4 kg/m^(2)≤ΔBMI≤6 kg/m^(2)组(BMI增长正常组;n=87)和ΔBMI>6 kg/m^(2)组(BMI增长过多组,n=62)。利用调查问卷发放的方式获取所有受试者的基线资料与实验数据,利用Logistic回归模型分析评估不同BMI变化与母婴结局的相关性。结果BMI增长过多组妊高症、先兆子痫、产后出血各占29.03%、18.03%、41.94%,BMI增长正常组各占19.54%、14.94%、12.64%,BMI增长不足组各占25.49%、7.84%、13.73%。②BMI增长过多组胎儿窘迫、巨大儿各占29.03%、40.32%,BMI增长正常组各占13.79%、14.94%,BMI增长不足组各占9.80%、7.84%。BMI增长过多组产后并发症发生率、新生儿结局不良率较BMI增长正常组、BMI增长不足组更高(P<0.05)。将BMI增长正常作为参照进行Logistic回归分析发现,BMI增长不足会增加妊高症、先兆子痫、产后出血、胎儿窘迫、巨大儿的发生风险(OR=3.376、2.658、1.354、1.713、2.165,P<0.05);BMI增长过多会增加妊高症、先兆子痫、产后出血、胎儿窘迫、巨大儿、低体重儿和GDM的发生风险(OR=2.647、1.659、3.675、4.132、2.876、3.151、3.325)。结论GDM产妇的BMI增长不足、BMI增长过多均会增加母婴结局的不良发生率,故在孕期内控制可监测孕妇的体重增长,不仅有利于母婴的健康,对降低GDM及相关并发症发生率也有积极的影响。

妊娠期血脂异常患病率及妊娠早期血脂水平预测价值研究

背景妊娠期血脂异常升高可对母儿健康造成不良影响,不仅增加了子痫前期、妊娠期糖尿病(GDM)、高甘油三酯胰腺炎、晚期流产、早产以及巨大儿的发生风险,亦显著增加了母儿产后心血管疾病的风险。目的分析妊娠早、中、晚期血脂异常的分布特征及其早期血脂水平对妊娠中、晚期血脂异常的预测价值。方法本研究为单中心回顾性研究,纳入2018年1月—2019年6月在首都医科大学附属北京妇产医院产科建档产检至分娩的单胎孕妇,收集临床资料及妊娠早、中、晚期血脂数据[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]。以首都医科大学附属北京妇产医院妊娠期血脂参考范围作为血脂异常诊断标准:包括高总胆固醇血症、高甘油三酯血症、低高密度脂蛋白胆固醇血症和高低密度脂蛋白胆固醇血症。采用二分类Logistic回归分析妊娠早期血脂水平与妊娠中、晚期血脂异常的相关性,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价妊娠早期血脂水平对妊娠中、晚期血脂异常的预测价值,根据灵敏度和特异度确定最佳截断值。结果研究共纳入单胎孕妇8511名,平均年龄为(31.7±3.9)岁,平均孕前BMI为(21.7±3.2)kg/m^(2),其中孕前低体质量988名(11.6%)、正常体质量5568名(65.4%)、超重1271名(14.9%)、肥胖366名(4.3%),GDM孕妇1415名(16.7%),妊娠期高血压疾病(HDP)孕妇650名(7.6%)。妊娠中、晚期TC、TG、LDL-C水平均高于妊娠早期(P<0.05),妊娠晚期HDL-C水平高于妊娠早期,但低于妊娠中期(P<0.05)。妊娠早期血脂异常患病率为23.4%(1990/8511),妊娠中、晚期血脂异常患病率低于妊娠早期(P<0.05)。孕前超重、肥胖孕妇妊娠早期血脂异常患病率高于孕前正常体质量孕妇,但妊娠晚期血脂异常患病率比较,差异无统计学意义(P>0.05);GDM组孕妇妊娠早、中期血脂异常患病率均高于非GDM孕妇,HDP孕妇妊娠早、中、晚期血脂异常患病率高于非HDP孕妇(P<0.05)。排除可能影响血脂的妊娠合并症及并发症后,妊娠早期预测妊娠中期血脂异常的最佳截断值分别为TC 4.485 mmol/L(AUC=0.854)、TG 1.325 mmol/L(AUC=0.864)、HDL-C 1.275 mmol/L(AUC=0.908)、LDL-C 2.265 mmol/L(AUC=0.823);妊娠早期预测妊娠晚期血脂异常的最佳截断值分别为TC 4.485 mmol/L(AUC=0.809)、TG 1.145 mmol/L(AUC=0.833)、HDL-C 1.285 mmol/L(AUC=0.851)、LDL-C 2.195 mmol/L(AUC=0.766)。结论妊娠期血脂异常患病率并未增加,不同孕前BMI、GDM与非GDM、HDP与非HDP孕妇之间妊娠期血脂异常患病率具有显著差异,妊娠早期血脂水平有预测妊娠中晚期血脂异常的价值。

妊娠期糖尿病孕妇风险感知评价指标的构建

目的通过德尔菲专家咨询法构建妊娠期糖尿病孕妇风险感知评价指标体系,为编制妊娠期糖尿病孕妇风险感知量表提供理论依据,进而为医护人员开展妊娠期糖尿病孕妇风险感知相关探索性研究提供评估工具。方法2022年7—8月通过对文献回顾及质性访谈形成的妊娠期糖尿病孕妇风险感知评价指标体系初稿,联系12名相关领域的专家进行2轮德尔菲专家咨询,使用专家积极系数、权威系数、肯德尔和谐系数验证咨询结果的可靠性。结果第1轮各指标均分范围为4.25~5.00,变异系数范围0.00~0.26;第2轮各指标均分范围为4.33~5.00,变异系数范围0.00~0.17。本研究中第1轮和第2轮的专家积极系数均为100%,专家权威系数分别为0.83、0.86,肯德尔和谐系数分别为0.143、0.163。2轮专家咨询最终形成6个一级指标、41个二级指标的妊娠期糖尿病孕妇风险感知评价指标体系。结论基于德尔菲专家咨询形成的妊娠期糖尿病孕妇风险感知评价指标体系具有一定科学性和可靠性,可为构建妊娠期糖尿病孕妇风险感知量表提供参考。

妊娠期糖尿病患者对开发饮食健康教育游戏小程序认知与需求的质性研究

目的探讨妊娠期糖尿病患者对开发饮食健康教育游戏小程序的需求。方法运用描述性质性研究方法,以目的抽样法选取产科15例妊娠期糖尿病患者为研究对象,进行半结构式深入访谈,采用内容分析法对资料进行分析并提炼主题。结果共提炼出4个主题、9个亚主题,即妊娠期糖尿病饮食教育信息获取方式(从专业医疗团队获取、从社交媒体平台获取)、对电子游戏的态度看法(对电子游戏的选择偏好、对饮食教育游戏小程序的态度)、对设计游戏小程序的期望(应用过程兼顾用户友好性及效益、获取全面丰富的妊娠糖尿病饮食信息、提供定制的个性化饮食信息)、游戏化健康教育所面临的挑战(游戏化场景的生动性与专业性、游戏场景的生活化)。结论开发妊娠期糖尿病饮食健康教育游戏小程序前,医护人员应充分了解患者的使用需求,从而为患者的饮食指导提供趣味性、可行性强的工具。

高龄GDM孕妇母婴结局及风险因素分析

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。

高危型孕妇血清sFkn、CXCL12水平与妊娠糖尿病、围生结局的关系

目的探讨高危型孕妇血清神经趋化蛋白(sFkn)、CXC趋化因子配体12(CXCL12)水平与妊娠糖尿病(GDM)、围生结局的关系。方法将2019年6月至2022年6月于该院孕检及生产的235例高危型孕妇纳入研究作为研究组,随访并记录纳入研究者是否发生GDM及其围生结局。另外,选取同期于该院体检的230例无高危因素的健康孕妇作为对照组。采用酶联免疫吸附法检测纳入研究者血清sFkn、CXCL12水平。采用受试者工作特性(ROC)曲线评估血清sFkn、CXCL12水平对高危型孕妇围生结局的预测价值。采用单因素分析和多因素Logistic回归分析高危型孕妇围生结局的影响因素。结果研究组血清sFkn、CXCL12水平高于对照组(P<0.05)。235例高危型孕妇在妊娠期发生GDM 49例(20.85%),出现不良围生结局34例(14.47%)。GDM组血清sFkn、CXCL12水平高于单纯高危组(P<0.05)。不良围生结局组血清sFkn、CXCL12水平高于正常围生结局组(P<0.05)。血清sFkn、CXCL12预测高危型孕妇患者围生结局的曲线下面积(AUC)分别为0.761(0.716~0.814)、0.839(0.796~0.889),两者联合预测的AUC为0.905(0.855~0.948)。不良围生结局组孕前体重指数(BMI)、孕次、产次及有糖尿病家族史、高血压家族史、GDM者比例高于正常围生结局组(P<0.05),孕期饮食调整者比例低于正常围生结局组(P<0.05)。多因素Logistic回归分析显示:孕前BMI≥28.0 kg/m^(2)(OR=3.604,95%CI:1.561~8.322)、GDM(OR=4.384,95%CI:1.668~11.522)、sFkn≥5.63 ng/mL(OR=4.707,95%CI:1.809~12.249)、CXCL12≥12.67 ng/mL(OR=5.217,95%CI:2.061~13.211)是高危型孕妇围生结局的影响因素(P<0.05)。结论高危型孕妇血清sFkn、CXCL12水平与GDM密切相关,并且对高危型孕妇者围生结局具有一定预测价值。

高龄经产妇再次妊娠患妊娠期糖尿病的危险因素分析

目的探讨高龄经产妇再次妊娠患妊娠期糖尿病(GDM)的潜在危险因素。方法选取医院2020年2月至2023年2月收治的GDM高龄经产妇50例作为观察组,另选取50例正常妊娠的高龄经产妇作为对照组。收集参与者的一般资料,同时关注多胎妊娠、肥胖、家族糖尿病史、生活习惯等潜在危险因素。结果观察组多胎妊娠的比例(56.00%)明显高于对照组(24.00%),肥胖的发生率(44.00%)明显高于对照组(16.00%),家族糖尿病史的比例(60.00%)显著高于对照组(20.00%),不良生活习惯的比例(90.00%)也明显高于对照组(40.00%)。结论多胎妊娠、肥胖、家族糖尿病史、不良生活习惯等因素是高龄经产妇再次妊娠患GDM的危险因素。但未考虑到其他可能的干扰因素,在未来的研究中可进一步扩大样本量研究,以获得更准确的结论。

不同治疗方式对妊娠期糖尿病孕妇血糖、尿酸的影响Meta分析

目的:通过对多个研究进行Meta分析,明确各种治疗方式对妊娠期糖尿病孕妇血糖、尿酸的影响。方法:通过文献检索数据库,收集有关不同治疗方式对妊娠期糖尿病孕妇血糖、尿酸影响的随机对照试验(RCT)和观察性研究。采用RevMan软件行Meta分析。结果:经筛选,共纳入7篇研究,均为RCT。共包括822例妊娠期糖尿病孕妇,其中接受常规胰岛素治疗的411例,接受其他方法治疗的411例。研究组干预期空腹血糖、餐后2 h血糖、尿酸均明显降低(P<0.01)。结论:不同治疗方式对妊娠期糖尿病孕妇血糖和尿酸水平有显著影响。采用其他方法治疗可能有更好的影响效果。

高龄对妊娠期糖尿病患者孕中期叶酸、维生素B12水平的影响

目的探讨高龄对妊娠期糖尿病(GDM)患者孕中期血清叶酸及维生素B12水平的影响,以及与妊娠结局的关系,以期为高龄GDM患者提供更好的临床诊疗和保健指导。方法选取2021年1月至2022年7月由定点社区医院转入我院产检并分娩的GDM患者212例,其中高龄GDM组(≥35岁)75例、适龄GDM组(<35岁)137例。比较两组患者孕中期血清叶酸及维生素B12水平,分析其与新生儿出生体质量等妊娠结局的相关性。结果高龄GDM组患者孕中期血清维生素B12水平显著低于适龄GDM组[(232.04±65.79)pmol/L vs.(257.62±92.86)pmol/L,P<0.05];两组孕妇血清叶酸及叶酸/维生素B12比值比较差异无统计学意义。高龄GDM组孕妇分娩孕周[(38.57±1.32)周vs.(38.95±1.32)周,P<0.05]及新生儿体质量[(3306.33±441.01)g vs.(3429.82±426.47)g,P<0.05]低于适龄GDM组。本研究未发现叶酸、维生素B12水平及叶酸/维生素B12与GDM患者新生儿出生体质量之间有显著相关性。结论高龄GDM患者孕中期体内的维生素B12缺乏更显著,其分娩的新生儿体质量较低,但未发现两者具有显著相关性。

综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果

目的观察综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果及对妊娠结局的影响效果。方法选取2021年7月至2022年6月收治于宿迁市第一人民医院的高龄妊娠期糖尿病患者90例为研究对象。采用随机数字表法将90例高龄妊娠期糖尿病患者分为试验组和对照组,每组45例。对照组遵循妊娠期糖尿病常规宣教法施护,试验组在此基础之上引入综合性早期饮食宣教指导干预机制,对2组干预后的各观察指标进行比较。结果试验组高龄妊娠期糖尿病患者饮食控制认知度评分、饮食控制依从性评分与对照组比较,差异均有统计学意义(P<0.05),试验组血糖控制成效测评指标优于对照组,不良妊娠结局率低于对照组(P<0.05)。结论采用综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇施加干预,利于其饮食控制认知度、依从度的提升,可取得较佳血糖控制成效、减低不良妊娠结局概率。

快速康复护理用于妊娠期糖尿病患者剖宫产围术期的效果评价

目的 评估妊娠期糖尿病患者剖宫产围术期护理中,快速康复护理的实施效果。方法 选取2021年1月—2023年10月庆阳市人民医院产科收治的68例妊娠期糖尿病患者为研究对象,所有患者均实施剖宫产,经抽签法分成研究组、对照组,各34例,分别实施快速康复护理、常规护理。比较两组患者血糖指标、术后切口感染率及满意度。结果 护理后,两组患者的血糖指标均低于护理前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组的术后切口感染率(2.94%)低于对照组(20.59%),差异有统计学意义(χ^(2)=5.100,P=0.024);研究组满意度高于对照组,差异有统计学意义(P<0.05)。结论 快速康复护理对降低术后切口感染率有积极意义,可以帮助患者改善血糖指标情况,可以满足患者合理护理需求。