论文部分内容阅读
目的调查深圳地区初产孕妇妊娠期糖尿病(gestational diabetes mellitus,GDM)的发病情况,分析影响GDM发病的危险因素,为GDM的预防、管理和早期干预提供理论依据。方法以2015年11月至2016年1月在深圳市妇幼保健院产检建卡的孕11~16周初产孕妇为研究对象,所有研究对象通过问卷调查收集一般资料,于孕24~28周行75 g口服葡萄糖耐量试验,采用Logistic回归分析法探讨GDM的危险因素。结果参与调查的600名初产妇中,有543名完成问卷调查和血糖检测,按照2010年国际糖尿病与妊娠研究组诊断标准,检出GDM患者37例,发生率6.8%。GDM组孕妇年龄、孕前BMI和建卡时体重均高于糖耐量正常(NGT)组(P<0.05);孕前超重及肥胖孕妇GDM发生率为17.1%,明显高于孕前体重正常孕妇(7.0%)和孕前体重偏低孕妇(3.2%),家庭收入较高的孕妇GDM发生率为14.7%,高于家庭收入中等(8.0%)和偏少(4.0%)的孕妇,每日静坐时间≥5 h孕妇GDM发生率高于静坐时间<5 h孕妇(8.0%vs 2.5%),差异均有统计学意义(P<0.05)。Logistic回归分析结果显示初产妇孕前BMI(OR=1.190;95%CI=1.044~1.356)、年龄(OR=1.108;95%CI=1.011~1.215)和每日静坐时间≥5 h(OR=3.741;95%CI=1.108~12.632)是GDM发生的危险因素。结论年龄、孕前BMI和每日静坐时间≥5 h是初产孕妇GDM发生的独立危险因素。深圳地区应尽早对初产妇进行高危因素筛查,加强管理,以减少GDM的发生。
Objective To investigate the incidence of gestational diabetes mellitus (GDM) in primiparous pregnant women in Shenzhen and to analyze the risk factors influencing the pathogenesis of GDM so as to provide a theoretical basis for the prevention, management and early intervention of GDM. Methods From November 2015 to January 2016, maternal and neonatal pregnant women of 11 to 16 weeks of gestation in Jianghua MCH from Shenzhen were enrolled in this study. All the subjects collected general information through questionnaire survey, 75 g oral glucose tolerance test, the use of Logistic regression analysis of risk factors for GDM. Results Among the 600 primipara women who participated in the survey, 543 completed the questionnaire and blood sugar test. According to the diagnostic criteria of the International Diabetes and Pregnancy Study Group in 2010, 37 cases of GDM were detected, the incidence rate was 6.8%. The GDM group had significantly higher GDM rate (17.1%) than that of the normal glucose tolerance group (P <0.05), pre-pregnancy GDM group (P <0.05) ) And pregnant women with low body weight before pregnancy (3.2%). The incidence of GDM in pregnant women with higher family income was 14.7%, higher than those with moderate (8.0%) and moderate (4.0%) family income. The daily meditation time was ≥5 h The incidence of GDM in pregnant women was higher than that of pregnant women <8.0 h vs 2.5% (P <0.05). Logistic regression analysis showed that the pre-pregnancy BMI (OR = 1.190; 95% CI = 1.044-1.356), age (OR = 1.108; 95% CI = 1.011-1.215) and daily sit-in ≥5 h 95% CI = 1.108 ~ 12.632) is a risk factor for GDM. Conclusion Age, pre-pregnancy BMI and daily sit-in time≥5 h are independent risk factors for GDM in primiparous pregnant women. Shenzhen early screening of high-risk primipara should be conducted to strengthen management to reduce the incidence of GDM.