本文選題：再生育 + 妊娠期糖尿病��； 參考：《衛(wèi)生研究》2017年06期

【摘要】：目的探討再生育孕婦妊娠期糖尿病(gestational diabetes mellitus,GDM)發(fā)病的相關(guān)危險(xiǎn)因素。方法于2015—2016年在廈門(mén)市婦幼保健院圍產(chǎn)營(yíng)養(yǎng)門(mén)診,按照孕期保健手冊(cè)的建卡編號(hào)隨機(jī)選擇393例GDM患者,并以年齡段為匹配因素進(jìn)行1∶1配對(duì),以393例糖耐量試驗(yàn)正常的孕婦作為對(duì)照組。收集妊娠前體質(zhì)指數(shù)、文化程度、流產(chǎn)次數(shù)、產(chǎn)檢時(shí)的孕周及體重、父母親患糖尿病史、上一胎胎兒出生體重、有無(wú)妊娠期糖尿病史等資料,兩組人群均為再生育孕婦。結(jié)果 (1)單因素分析顯示:GDM組孕婦孕24周前體重增長(zhǎng)高于對(duì)照組[(9.11±3.09)kg vs(7.54±2.95)kg,t=2.121,P=0.004],母親患糖尿病的比例高于對(duì)照組(64/393 vs 38/393,χ~2=7.616,P=0.006),而對(duì)照組文化程度總體水平高于GDM組(Z=-4.060,P=0.001)。配對(duì)卡方分析顯示,巨大兒分娩史(χ~2=14.297,P=0.001)、妊娠期糖尿病史(χ~2=12.938,P=0.001)及流產(chǎn)次數(shù)≥2次(χ~2=7.078,P=0.010)均是再生育孕婦發(fā)生GDM的危險(xiǎn)因素。隨著上一胎胎兒出生體重的增長(zhǎng),下一孕期GDM發(fā)病的風(fēng)險(xiǎn)也逐漸增加。當(dāng)出生體重達(dá)到3.8 kg時(shí),OR=3.467,該風(fēng)險(xiǎn)值達(dá)到強(qiáng)相關(guān)程度。(2)多因素Logistic回歸分析顯示:單因素分析中,差異有統(tǒng)計(jì)學(xué)意義的危險(xiǎn)因子均是GDM發(fā)病的高危因素,其中孕24周前體重增長(zhǎng)超過(guò)10 kg的影響最大(OR=1.875,P=0.001)。結(jié)論妊娠期糖尿病史、巨大兒分娩史、流產(chǎn)次數(shù)≥2次、妊娠24周前體重總增長(zhǎng)超過(guò)10 kg、文化程度水平相對(duì)低、孕婦母親患糖尿病史均是GDM發(fā)病的危險(xiǎn)因素;對(duì)于上一胎胎兒出生體重達(dá)到3.8 kg以上的再生育孕婦,應(yīng)被納入GDM發(fā)病的高危人群。
[Abstract]:Objective to investigate the risk factors associated with gestational diabetes mellitusus (GDM) in pregnant women with gestational diabetes mellitus (GDM). Methods 393 patients with GDM were randomly selected in the perinatal nutrition clinic of Xiamen Maternal and Child Health Hospital from 2015 to 2016. 393 patients with GDM were randomly selected according to the establishment card number of the health care manual during pregnancy. 393 pregnant women with normal glucose tolerance test were used as control group. The data of body mass index (BMI) before pregnancy, education level, abortion frequency, gestational weeks and body weight during birth examination, parents history of diabetes mellitus, birth weight of the last fetus, history of gestational diabetes mellitus and so on were collected. The two groups were all pregnant women. Results (1) univariate analysis showed that the weight gain before 24 weeks of gestation was higher in the w GDM group than that in the control group [9.11 鹵2.95 3.09)kg vs(7.54 鹵2.121kg. P0. 004], and the incidence of diabetes in the mother was higher than that in the control group (64 / 393 vs 38 / 393, 蠂 ~ (2 +) 7.616P0. 006), while the overall educational level in the control group was higher than that in the GDM group. Matched chi-square analysis showed that the history of macrosomia delivery (蠂 2 / 14.297), history of gestational diabetes mellitus (蠂 ~ 2 / 2 = 12.938 / P ~ 0.001) and the number of miscarriages 鈮，

本文編號(hào)：2001257