妊娠期糖尿病产后糖代谢异常的危险因素

目的通过对妊娠期糖尿病(GDM)患者进行产后随访,回顾性分析影响GDM患者产后糖代谢变化的高危因素。方法收集2009年1月至2011年6月在河北省沧州市中心医院门诊产前检查并分娩的GDM患者236例,产后42d回访者158例,记录其孕前和孕期信息,包括:孕期年龄、身高、孕前体重、有否糖尿病家族史、孕期使用胰岛素情况、孕期并发症及合并症情况、新生儿出生时情况;并按OGTT试验结果分为研究组和对照组,进行高危因素筛查。结果研究组为60例糖耐量异常者,包括39例IGT/IFG患者和21例DM患者;对照组为98例糖耐量正常者,比较两组患者孕前、孕期和妊娠结局情况,结果可见高龄、糖尿病家族史、孕期应用胰岛素、合并子痫前期、早产是产后发生糖代谢异常的高危因素,差异有统计学意义(P<0.05)。结论存在高危因素的GDM患者产后糖代谢异常发生率较高,应针对性地对GDM患者进行产后临床筛查和随访。

Risk factors of postpartum abnormal glucose metabolism in women with gestational diabetes mellitus

Objective To investigate the postpartum glucose metabolism in women with history of gestational diabetes mellitus （GDM） and to analyze the high risk factors of abnormal postpartum glucose metabolism. Methods There were totally 236 GDM patients were treated in the Central Hospital of Cangzhou during January 2009 to June 2011, 158 of them were under follow- up. The medical records of the 158 cases during pregnancy including age, height, weight before pregnant, family history of diabetes, insulin using, pregnancy complications, neonatal weight and blood sugar were analyzed retrospectively. All patients underwnt Oral Glucose Tolerance Test （OGTT） at 6 weeks after delivery, according to the OGTT result, patients were divided into study group and control group, risk factors that related to abnormal glucose metabolism were screened. Results There were 60 abnormal glucose metabolism patients including 39 IGT/IFG patients and 21 cases of DM in the study group. The control group was composed of 98 cases of normal glucose metabolism. Advanced age, family history of diabetes, insulin using during pregnancy, preeclampsia, premature delivery were risk factors of abnormal glucose metabolism. Conclusion GDM patients with high risk factors were prone to have abnormal glucose regulation postpartum and should be under close follow- up.