妊娠糖尿病患者产后6~12周糖代谢转归及相关因素探讨

  目的  探讨妊娠期糖尿病(GDM)患者产后6~12周糖代谢情况和相关影响因素，为预防妊娠糖尿病患者产后糖代谢异常提供理论参考。  方法  选择慈溪市人民医院2019年1月—2020年1月期间收治的GDM患者作为研究对象，依据患者产后6~12周的糖代谢不同结局分为糖代谢正常组(120例)和糖代谢异常组(80例)，比较分析2组患者孕前、孕中和新生儿相关指标。  结果  单因素分析显示GDM患者产后6~12周糖代谢异常的影响因素包括年龄、糖尿病家族史、孕前BMI、OGTT FPG和OGTT 2hPG，差异均具有统计学意义(均P＜0.05)；多因素分析显示GDM患者产后6~12周糖代谢异常的独立危险因素有年龄(OR=2.177，P=0.002)、孕前BMI(OR_肥胖=3.062，P=0.001；OR_超重=0.038，P=0.036；OR_正常=0.002，P=0.001)和糖尿病家族史(OR=6.968, P=0.030)。  结论  GDM患者产后出现糖代谢异常可能与患者年龄、糖尿病家族史以及孕前BMI有关，临床医师在诊疗过程中应警惕相关危险因素，针对以上情况做好随访和防控措施，降低GDM患者产后糖代谢异常发生几率。 

Study on the outcome of glucose metabolism and related factors in gestational diabetes mellituss at 6-12 weeks postpartum

  Objective  To discuss the effects of glucose metabolism and related factors in gestational diabetes mellitus (GDM) patients at 6-12 weeks postpartum on GDM and to provide theoretical reference for preventing abnormal glucose metabolism in GDM patients.  Methods  GDM inpatients who met the requirements in our hospital from January 2019 to January 2020 were selected for the study and divided into the abnormal glucose metabolism group (80 cases) and normal glucose metabolism group (120 cases) on the basis of the results of 6-12 weeks postpartum glucose metabolism. Pre-pregnancy, mid-pregnancy and neonatal-related indicators were compared and analysed between the two groups.  Results  Univariate analysis showed that GDM patients had significant differences in age, family history of diabetes, pre-pregnancy BMI, oral glucose tolerance test (OGTT) FPG and OGTT 2hPG; all the differences were statistically significant (P < 0.05). Multivariate analysis showed that age (OR=2.177, P=0.002), pre-pregnancy BMI (OR_fat=3.062, P=0.001; OR_overweight=0.038, P=0.036) and family history of diabetes (OR=6.968, P=0.030)were independent risk factors for glucose metabolism abnormalities in GDM patients at 6-12 weeks postpartum.  Conclusion  Abnormal postpartum glucose metabolism in GDM patients may be related to patient's age, family history of diabetes and BMI before pregnancy. Clinicians should be alert to the relevant risk factors during diagnosis and treatment, and follow-up and preventive and control measures should be taken to reduce the incidence of postpartum glucose metabolism abnormalities in GDM patients.