浙江省舟山群岛地区妊娠期糖尿病流行情况及影响因素研究

目的描述浙江省舟山地区孕妇妊娠期糖尿病（GDM）的流行情况并分析其影响因素。方法采用回顾性调查研究，对2014年1月至2018年6月舟山市妇幼保健院GDM筛查情况进行分析，并采用logistic回归模型分析GDM及其亚型的影响因素。结果采用口服葡萄糖耐量试验（OGTT）筛查的10 802名孕妇中，GDM患病率为13.78%；其中，亚型A（单纯空腹型）占21.49%，亚型B（单纯餐后型）占66.15%，亚型C（空腹与餐后型）占12.36%。 多因素logistic回归分析显示，年龄较大、孕早期体质指数（BMI）高、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季和初产妇等因素增加GDM的发生风险，而文化程度与GDM无关。 不同亚型GDM多分类logistic回归分析显示，孕早期BMI高、孕早期血糖高、OGTT筛查时间为冬春季等因素增加GDM亚型A发生的风险；年龄较大、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季和高文化程度等因素增加GDM亚型B的发生风险，而经产妇则降低GDM亚型B的发生风险。 年龄较大、孕早期BMI高、孕早期血糖高、孕早期心率快、OGTT筛查时间为冬春季等因素增加GDM亚型C的发生风险，而文化程度高和经产妇则降低GDM亚型C的发生风险。结论舟山地区GDM的发病率较高，年龄较大、孕早期BMI高、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季等因素与GDM的发病有关。 因此，应加强健康宣教，避免高龄妊娠。 同时，重视围产期保健和GDM筛查，控制孕前BMI，促进母婴健康。

Incidence of gestational diabetes mellitus and risk factors in Zhoushan Islands,Zhejiang

ObjectiveTo understand the incidence of gestational diabetes mellitus (GDM) in pregnant women in Zhoushan, Zhejiang province, and identify its influencing factors.MethodsThe data of all the pregnant women underwent GDM screening in Zhoushan Maternal and Child Care Center from January 2014 to June 2018 were retrospectively analyzed in this study. Logistic regression models were used for the identification of the risk factors for GDM and GDM subtypes.ResultsA total of 10 802 pregnant women received GDM screening, the oral glucose tolerance test indicated that 1 489 pregnant women had GDM (13.78%). The proportions of different GDM subtypes (A, B and C) were 21.49%, 66.15% and 12.36%, respectively, in 1 489 GDM cases. The multivariate logistic regression analysis showed that older age, higher BMI during early pregnancy, higher blood glucose level during early pregnancy, higher heart rate during early pregnancy, higher albumin level during early pregnancy, screening in winter/spring and being primipara were the risk factors for GDM, while educational level was not associated with the risk for GDM. The multiple logistic regression analysis for different GDM subtype showed that higher BMI, higher blood glucose level during early pregnancy and screening in winter/spring were associated with increased risks for GDM subtype A. Older age, higher blood glucose level, higher heart rate and higher albumin level during early pregnancy, screening in winter/spring and higher educational level were associated with increased risk for GDM subtype B, while being multipara decreased the risk for GDM subtype B. Older age, higher BMI, higher heart rate and higher blood glucose level during early pregnancy, and screening in winter/spring were associated with increased risk for GDM subtype C, while higher educational level and being multipara decreased the risk for GDM subtype C.ConclusionThe incidence of GDM was high in Zhoushan. Older age, higher BMI, higher blood glucose level, higher heart rate and high albumin level during early pregnancy, screening in winter/spring increased the risk for GDM, respectively. It is important to avoid pregnancy at older age and control pre-pregnancy BMI and blood glucose level during early pregnancy to reduce the risk for GDM and improve the health of both mothers and infants.