妊娠期糖尿病孕妇产后高血糖的危险因素分析

  目的  了解妊娠期糖尿病(GDM)孕妇产后高血糖情况，并分析GDM孕妇产后高血糖的影响因素。  方法  选取2017年5月—2020年2月在海南省文昌市人民医院门诊就诊的GDM孕妇206例，根据产后2个月的75 g口服葡萄糖耐量试验(OGTT)结果分为产后高血糖组(54例)和产后血糖正常组(152例)。收集2组孕妇的一般临床资料，对其产后高血糖发生的影响因素进行分析。  结果  206例GDM孕妇产后发生高血糖共54例，产后高血糖发生率为26.21%。单因素分析结果显示，年龄、孕期BMI、巨大胎儿、糖尿病(DM)家族史、孕期OGTT异常项次、孕期使用胰岛素治疗、产后BMI、孕期空腹血糖水平、产后运动与GDM孕妇产后高血糖相关(均P < 0.05)；经logistic回归分析显示，年龄(OR=2.261, P=0.023)、DM家族史(OR=3.865, P=0.001)、产后BMI(OR=2.502, P=0.020)、孕期空腹血糖(OR=2.130, P=0.029)、孕期OGTT异常项次增多(OR=4.864, P < 0.001)、孕期使用胰岛素治疗(OR=3.251, P=0.001)是GDM孕妇产后高血糖的独立影响因素。  结论  年龄、DM家族史、产后BMI、孕期OGTT异常项次增多、孕期空腹血糖、孕期使用胰岛素治疗是GDM孕妇产后高血糖的独立影响因素，临床上应采取积极的干预措施，预防产后高血糖的发生。 

Risk factors of postpartum hyperglycaemia in pregnant women with gestational diabetes mellitus

  Objective  To investigate postpartum hyperglycaemia in pregnant women with gestational diabetes mellitus (GDM) and analyse the influencing factors of postpartum hyperglycaemia in pregnant women with GDM.  Methods  A total of 206 pregnant women with GDM who were admitted to the outpatient department of Wenchang City People ' s Hospital from May 2017 to February 2020 were selected. According to the results of 75 g oral glucose tolerance test (OGTT) at 2 months postpartum, the patients were divided into the postpartum hyperglycaemia group (54 cases) and postpartum normal blood glucose group (152 cases). The general clinical data of pregnant women in the two groups were collected, and the influencing factors of postpartum hyperglycaemia were analysed.  Results  Postpartum hyperglycaemia occurred in 54 of 206 pregnant women with GDM, and the incidence of postpartum hyperglycaemia was 26.21%. Univariate analysis showed that age, pregnancy body mass index, body mass index (BMI), macrosomia, diabetes (diabetes mellitus, DM) family history, pregnancy OGTT abnormality, using insulin therapy during pregnancy and postpartum BMI, fasting blood glucose level during pregnancy and postpartum movement were closely related to postpartum hyperglycaemia in GDM pregnant women (all P < 0.05). According to logistic regression analysis, Age (OR=2.261, P=0.023), family history of DM (OR=3.865, P=0.001), postpartum BMI (OR=2.502, P=0.020), fasting blood glucose during pregnancy (OR=2.130, P=0.029), increased number of abnormal OGTT during pregnancy (OR=4.864, P < 0.001) and insulin treatment during pregnancy (OR=3.251, P=0.001) were independent risk factors for postpartum hyperglycemia in GDM pregnant women.  Conclusion  Age, DM family history, postpartum BMI, increased OGTT abnormalities during pregnancy, fasting blood glucose during pregnancy and insulin treatment during pregnancy are independent risk factors for postpartum hyperglycaemia in GDM pregnant women. Therefore, active intervention measures should be taken clinically to prevent postpartum hyperglycaemia.