南充地区妊娠期糖尿病危险因素及妊娠结局分析

目的 探讨南充地区妊娠期糖尿病(gestational diabetes mellitus,GDM)的危险因素及妊娠结局,为南充地区育龄妇女GDM防治提供参考依据。方法 选取2018年7月1日至2019年9月30日在川北医学院附属医院产检并住院分娩的孕产妇1 800例,其中确诊GDM 537例(GDM组),血糖正常1 263例(NGT组),分析GDM的发病率、危险因素及妊娠结局。结果 南充地区GDM发病率为29.83%。年龄、居住地、产前体重指数(body mass index,BMI)、多囊卵巢综合征(PCOS)、乙型病毒性肝炎表面抗原(HBsAg)、妊娠期高血压疾病(HDP)、妊娠期甲状腺功能、瘢痕子宫、体外受精(IVF)、流产史及分娩史与GDM发病相关;GDM与剖宫产、HDP、妊娠期肝内胆汁淤积症(ICP)、产后出血、早产、巨大儿发病相关(均P<0.05)。年龄、居住地、产前BMI、PCOS、HBsAg、HDP、妊娠期甲状腺功能、IVF及流产史是GDM发病的危险因素;GDM是剖宫产、HDP、ICP、产后出血及巨大儿发病的危险因素(均P<0.05)。结论 南充地区GDM发病率可能与年龄、居住地、产前BMI、PCOS、HBsAg、HDP、妊娠期甲状腺功能、IVF及流产史有密切联系;GDM孕产妇剖宫产、HDP、ICP、产后出血及分娩巨大儿的风险较高。

Risk factors and pregnancy outcomes of gestational diabetes mellitus in Nanchong area

Objective To discuss the risk factors and pregnancy outcomes of gestational diabetes mellitus(GDM) for GDM prevention and treatment in Nanchong area. Methods This study enrolled 1,800 pregnant women who performed prenatal check-up and delivery in Affiliated Hospital of North Sichuan Medical College from July 1, 2018 to September 30, 2019. Among the subjects, 537 cases were diagnosed GDM (GDM group), 1,263 cases with normal blood glucose (NGT group).The key observation involved the incidence, risk factors and pregnancy outcomes of GDM. Results In Nanchong area, the incidence of GDM was 29.83%. Age, residence, prenatal body mass index(BMI), polycystic ovary syndrome(PCOS), hepatitis B surface antigen(HBsAg), hypertensive disorder of pregnancy(HDP), thyroid function during pregnancy, scar uterus, in vitro fertilization(IVF), abortion history and delivery history were related to the onset of GDM. GDM was related to cesarean section, HDP, intrahepatic cholestasis of pregnancy(ICP), postpartum hemorrhage, preterm delivery, and macrosomia(all P<0.05). The risk factors of GDM were age, residence, prenatal BMI, PCOS, HBsAg, HDP, thyroid function during pregnancy, IVF and abortion history. GDM was a risk factor for cesarean section, HDP, ICP, postpartum hemorrhage and macrosomia (all P<0.05). Conclusion In Nanchong area, the incidence of GDM may be closely related to age, residence site, prenatal BMI, PCOS, HBsAg, HDP, thyroid function during pregnancy, IVF and abortion history. The risks of cesarean section, HDP, ICP, postpartum hemorrhage and macrosomia were higher in pregnant women with GDM.