2013-2017年北京市通州区34637例孕妇妊娠期糖尿病流行情况及其影响因素研究

  目的  了解北京市通州区孕妇妊娠期糖尿病（gestational diabetes mellitus，GDM）的流行情况及其相关影响因素。  方法  收集2013年1月1日至2017年12月31日期间在北京市通州区妇幼保健院住院分娩的34 637例单胎孕妇的社会人口学特征、既往史、糖尿病家族史及本次妊娠情况等资料，分析孕妇GDM患病率，利用多因素Logistic回归分析GDM相关影响因素。  结果  34 637例单胎孕妇的GDM患病率为23.19%（8 034/34 637）。多因素分析显示，高龄（aOR=1.87，95%CI:1.71~2.05）、高文化程度（aOR=1.19~1.23）、2016-2017年分娩（aOR=1.46，95%CI:1.38~1.55）、巨大儿分娩史（aOR=1.27，95%CI:1.02~1.59）、剖宫产史（aOR=1.18，95%CI:1.08~1.30）、自然流产史（aOR=1.23，95%CI:1.10~1.37）、药物及人工流产史（aOR=1.08，95%CI:1.01~1.14）、糖尿病家族史（aOR=1.51，95%CI:1.26~1.83）、经产妇（aOR=1.24，95%CI:1.15~1.34）、孕前超重（aOR=2.02，95%CI:1.89~2.15）、孕前肥胖（aOR=3.11，95%CI:2.81~3.43）、采用辅助生殖技术怀孕者（aOR=1.47，95%CI:1.03~2.10）是GDM的独立危险因素。  结论  北京市通州区住院分娩的孕妇中GDM处于较高的流行水平。应针对影响GDM发病的相关危险因素，开展孕前及孕期健康教育，及时监测及预防GDM的发生，以促进母婴健康。

Prevalence of gestational diabetes mellitus and its related risk factors among 34 637 pregnant women in Tongzhou district of Beijing from 2013 to 2017

  Objective  The study aims to investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Tongzhou district of Beijing and its related risk factors.  Methods  Information of 34 637 singleton pregnancies delivered in a maternal and child health care hospital in Tongzhou district of Beijing were collected from January 1, 2013 to December 31, 2017. GDM prevalence of pregnant women were calculated. Multivariable logistic regression analysis was used to analyze the association between GDM and its related factors.  Results  The prevalence of GDM in 34 637 singleton pregnant women in Tongzhou district of Beijing was 23.2% (8 034/34 637). Multivariate analysis showed that advanced maternal age(aOR=1.87, 95% CI: 1.71-2.05), high level of education(aOR=1.19-1.23), delivering during 2016-2017(aOR=1.46, 95% CI: 1.38-1.55), macrosomia(aOR=1.27, 95% CI: 1.02-1.59), history of cesarean section(aOR=1.18, 95% CI: 1.08-1.30), history of spontaneous abortion(aOR=1.23, 95% CI: 1.10-1.37), history of induced abortion(aOR=1.08, 95% CI: 1.01-1.14), family history of diabetes(aOR=1.51, 95% CI: 1.26-1.83), multipara(aOR=1.24, 95% CI: 1.15-1.34), pre-pregnancy overweight(aOR=2.02, 95% CI: 1.89-2.15), pre-pregnancy obesity(aOR=3.11, 95% CI: 2.81-3.43)and conceived by assisted reproductive technology(aOR=1.47, 95% CI: 1.03-2.10)were the independent risk factors for GDM.  Conclusions  Prevalence of GDM is high in pregnant women in Tongzhou district of Beijing. Health education before and during pregnancy should be carried out to monitor and prevent the occurrence of GDM in time to ensure maternal and child health.