2017年成都市孕早中期妇女铁补充剂摄入量对妊娠期糖尿病的影响

目的探讨成都地区孕早中期妇女铁补充剂摄入量对妊娠期糖尿病(gestational diabetes mellitus,GDM)的影响。方法采用前瞻性研究,于2017年2—4月通过立意抽样方法选取成都市某妇幼保健机构产前门诊807名孕早期妇女为研究对象。通过问卷调查于孕早期收集孕妇基本信息,于孕早、中期收集孕妇铁补充剂摄入剂量及频率,计算铁补充剂平均日摄入量,采用连续3天24小时膳食回顾法收集孕妇孕早、中期食物摄入量。根据WHO推荐孕期补铁60 mg/d为分界点,<60 mg/d为低水平组,≥60 mg/d为高水平组。于孕24～28周进行口服葡萄糖糖耐量试验,根据《中国妊娠合并糖尿病诊治指南(2014)》诊断GDM。采用多因素非条件Logistic回归方法分析孕早、中期妇女铁补充剂平均摄入量和摄入水平对GDM的影响。结果最终纳入有效样本739例,年龄(28.22±3.75)岁。孕早、中期铁补充剂使用率分别为5.0%和67.9%,铁补充剂摄入量≥60 mg/d比例分别为3.8%和47.1%。调整年龄、孕次、产次、孕前体质指数、膳食铁摄入量、膳食能量摄入量等混杂因素后,孕中期铁补充剂平...

Effects of iron supplement intake on gestational diabetes mellitus in early and middle pregnancy in Chengdu City in 2017

OBJECTIVE To explore the effect of iron supplement intake on gestational diabetes mellitus(GDM) in early and middle pregnancy. METHODS From February to April 2017, a prospective study was conducted among 807 early pregnant women in a prenatal clinic of a maternal and child medical institution in Chengdu City through purposive sampling. Data on maternal demographic characteristics was collected through questionnaire in early pregnancy. In early and middle pregnancy, the information of iron supplement intake were collected with questionnaire, 3-day 24 hour dietary recall method was used to assess maternal diet. According to the WHO recommendation, 60 mg/d iron supplementation during pregnancy was used as the dividing point,<60 mg/d iron supplementation was used as the low level group, and ≥60 mg/d iron supplementation was used as the high level group. At the 24 th to 28 th pregnant week, the oral glucose tolerance test(OGTT) was conducted, and GDM was diagnosed according to the Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes in China(2014). Multivariate unconditional Logistic regression model was used to analyze the effect of iron supplement intake on gestational diabetes mellitus(GDM) in early and middle pregnancy. RESULTS A total of 739 valid samples were followed up, the age was(28.22±3.75) years old. In early and middle pregnancy, the rate of taking iron supplementation was 5.0% and 67.9%, 3.8% and 47.1% of them iron supplement intake was more than 60 mg/d. After adjustmenting for body mass index, age, dietary iron, etc. Multivariate unconditional Logistic regression analysis showed that there was a positive correlation between the average intake of iron supplement and the occurrence of GDM in women during the second trimester of pregnancy(OR=1.059,95%CI 1.016-1.104). Compared with the lower iron supplement intake(<60 mg/d) women in midpregnancy, the risk of GDM was 1.406 times(95%CI 1.019-1.939)in the higher iron supplement intake(≥60 mg/d) women. No correlation was found between iron intake in early pregnancy and the occurrence of GDM. CONCLUSION Iron supplement intake during pregnancy may increase the risk of GDM. Appropriate intake of iron supplement for pregnant women is worth discussing.