单纯空腹血糖升高的妊娠期糖尿病孕妇母婴结局的影响因素分析

目的分析单纯空腹血糖升高的妊娠期糖尿病(GDM)孕妇母婴结局的影响因素。方法选择该院产科门诊2018年10月—2020年10月117例单纯空腹血糖升高的GDM孕妇作为研究对象,所有孕妇均随访至分娩后,根据母婴结局分为母婴结局良好组(n=69)和母婴结局不良组(n=48),收集孕妇年龄、孕前体质量指数(BIM)、糖化血红蛋白、口服葡萄糖耐量试验(OGTT)各次血糖值等资料,对2组相关指标进行单因素分析,将有统计学意义的变量纳入Logisitc回归模型进行多因素分析。结果结局不良组年龄≥35岁的构成比例为29.17%,高于结局良好组的13.04%;结局不良组孕前体质过重、肥胖的构成比例为33.33%、14.59%,高于结局良好组的10.14%、2.90%;产前BMI≥24.0 kg/m2的构成比例为47.92%,高于结局良好组的26.09%,差异有统计学意义(P<0.05)。结局不良组口服葡萄糖2 h 75 gOGTT为(7.18±1.49)mmol/L,高于结局良好组的(6.81±1.28)mmol/L,差异有统计学意义(P<0.05)。年龄≥35岁、孕前过重、肥胖、产前BMI≥24.0 kg/m2是影响单纯空腹血糖升高GDM孕妇母婴结局的主要因素(OR=1.516,1.863,1.317,95%CI=1.128~1.863,1.471~3.729,1.027~1.783)。结论年龄≥35岁、孕前过重、肥胖、产前BMI≥24.0 kg/m2是单纯空腹血糖升高GDM孕妇母婴不良结局的高危险因素,对于合并上述一种或多种因素者可进行干预,而无上述危险因素的孕妇则不必过度干预。

Analysis of Influencing Factors on Maternal and Infant Outcome of Pregnant Women with Gestational Diabetes Mellitus with Elevated Fasting Blood Glucose

Objective To analyze the influencing factors of maternal and infant outcomes of pregnant women with gestational diabetes mellitus(GDM)with elevated fasting blood glucose.Methods From October 2018 to October 2020,117 pregnant women with GDM with elevated fasting blood glucose in the hospital were selected as the research subjects.All pregnant women were followed up until after delivery.According to the maternal and infant outcome,they were divided into a good maternal and infant outcome group(n=69)and the poor maternal and infant outcome group(n=48),collect the data of pregnant women’s age,pre-pregnancy body mass index(BIM),glycosylated hemoglobin,and oral glucose tolerance test(OGTT)each blood glucose level.Factor analysis,incorporating statistically significant variables into the Logisitc regression model for multivariate analysis.Results The proportion of the poor outcome group aged≥35 years old was 29.17%,which was higher than 13.04%of the good outcome group;the poor outcome group constituted 33.33%and 14.59%of pre-pregnancy overweight and obesity,which were higher than 10.14%,2.90%of the good outcome group;the proportion of prenatal BMI≥24.0 kg/m2 was 47.92%,which was higher than 26.09%of the good outcome group,and the differences were statistically significant(P<0.05).The 2 h 75 gOGTT of oral glucose in the poor outcome group was(7.18±1.49)mmol/L,which was higher than that of the good outcome group(6.81±1.28)mmol/L,and the difference was statistically significant(P<0.05).Age≥35 years,pre-pregnancy overweight,obesity,prenatal BMI≥24.0 kg/m2 were the main factors affecting the maternal and infant outcome of GDM pregnant women with simple fasting blood glucose increase(OR=1.516,1.863,1.317,95%CI=1.128~1.863,1.471~3.729,1.027~1.783).Conclusion Age≥35 years old,pre-pregnancy overweight,obesity,and prenatal BMI≥24.0 kg/m2 were high risk factors for adverse maternal and infant outcomes in GDM pregnant women with elevated fasting blood glucose.Intervention can be provided for those with one or more of the above factors,and pregnant women without the above-mentioned risk factors do not need to over-intervene.