孕前空腹血糖及体质指数对妊娠期糖尿病的预测价值?

目的：探讨孕前空腹血糖(FPG)及体质指数(BMI)对妊娠期糖尿病(GDM)的预测价值。方法选取416例孕妇为研究对象，收集其临床资料，统计 GDM 发生率，对比 GDM 及非 GDM 孕妇的临床资料及妊娠结局，分析 GDM 发生的相关因素及其对 GDM 的预测价值。结果416例孕妇中，诊断为 GDM 者68例(16.35%)，非 GDM 者348例(83.65%)。GDM 组孕前舒张压、FPG、BMI 及孕24~28周 FPG 均高于非 GDM 组，差异有统计学意义(P <0.05或 P <0.01)。GDM 组与非 GDM 组新生儿体质量、剖宫产率、早产率和新生儿并发症发生率等指标比较，差异有统计学意义(P <0.05或 P <0.01)。logistic 回归分析表明，孕前 FPG、BMI 与 GDM 发生密切相关(P <0.05或 P <0.01)，其诊断 GDM 的受试者工作特征(ROC)曲线下面积分别为0.682、0.571。结论孕前FPG、BMI 与 GDM 发生密切相关，孕前6个月内做好相关筛查工作对预防 GDM 的发生具有重要意义。

Predictive Value of Pre-pregnant Fasting Plasma Glucose and Body Mass Index for the Gestational Diabetes Mellitus

Objective To explore the predictive value of pre-pregnant fasting plasma glucose (FPG)and body mass index (BMI)for the gestational diabetes mellitus (GDM).Methods A total of 41 6 pregnant women was selected as research objects and their clinical data and the GDM incidence were collected.Then the clinical data and the pregnancy outcomes between the women with GDM and those without were compared and analyzed to explore the contributing factors of the GDM incidence and their predictive values for GDM.Results 68 cases out of the 41 6 pregnant women were diagnosed with GDM and the other 348 cases were with no GDM.The data including diastolic pressure,FPG,BMI and FPG between the 24th week and 28th week in the GDM group were significantly higher than in the non-GDM group (P < 0.05 or P < 0.01 ).There were also significant differences between the GDM group and the non-GDM group in the neonatal body weight,the rate of cesarean section,the incidence of premature delivery and neonatal complications (P <0.05 or P <0.01).Logistic regression analysis revealed that pre-pregnant FPG and BMI were closely correlated with the GDM incidence (P <0.05 or P <0.01 ),and their areas under the curve of receiver operating characteristic (ROC)in the diagnosis of GDM were 0.682 and 0.571 respectively. Conclusion The pre-pregnant FPG and BMI are closely correlated with the GDM incidence.Therefore,the relevant screening work within 6 months before pregnancy is of great significance for preventing the GDM incidence.