【摘要】：目的:本研究主要探討二胎政策后黃島區(qū)孕婦妊娠期糖尿病的患病率及相關危險因素。方法:采用整群隨機抽樣的方法分別抽取青島大學附屬醫(yī)院黃島院區(qū)、開發(fā)區(qū)人民醫(yī)院和黃島區(qū)中醫(yī)院,于2016年1月1日至7月31日對在青島市黃島區(qū)建立孕產(chǎn)婦保健手冊在以上三家醫(yī)院接受75g-2h口服葡萄糖耐量試驗(oral glucose tolerance test,OGTT)的單胎妊娠孕婦進行調(diào)查研究,收集臨床實驗檢查資料。經(jīng)過計算樣本量至少需要4681,本次共調(diào)查4959名孕婦。對妊娠期糖尿病(gestational diabetes mellitus,GDM)的篩查采用國際糖尿病協(xié)會與妊娠研究組織(International Association of Diabetes and Pregnancy Study Group,IADPSG)新的診斷標準即空腹血糖≥5.10mmol/L或者1小時血糖≥10.00 mmol/L或者2小時血糖≥8.50 mmol/L,只要一項超過界值就可以診斷為GDM。定量資料組間比較采用t檢驗,定性資料組間比較采用χ2檢驗。應用Logistic回歸分析調(diào)查相關危險因素,其中GDM是因變量,相關風險因素被認為是自變量。Logistic回歸分析優(yōu)勢比(OR)和95%置信區(qū)間(CI)對GDM的危險因素進行單因素和多因素分析。p0.05為差異有統(tǒng)計學意義。結果:1.全區(qū)共調(diào)查孕婦4959人,數(shù)據(jù)顯示年齡25歲組為402人,25~29歲組為2436人,30~34歲組為1422人,≥35歲組為699人,其中25~29歲組所占比例最大為49.1%,其次是30~34歲組為28.7%。2.孕婦文化程度主要集中在本科和�？�,分別占38.4%和33.2%。兩組之和高達71.6%。3.家庭月總收入分布情況看,5000-6999元和7000-9999元所占比例最大,分別是27.7%和33.4%。4.孕婦中孕次為1的比例占49.80%,其次是孕次為2的占33.8%,孕次≥3的是16.30%,一胎孕婦占到65%,二胎及以上的孕婦占到35%。5.根據(jù)IADPSG診斷標準GDM患病率為21.8%(1080/4959),其中non-GDM和GDM組的平均孕周分別為(35.65±2.67)和(35.33±2.62),孕周在兩組之間沒有差異(p=0.706)。孕婦的平均年齡GDM組高于non-GDM組(32.01±4.32和29.23±3.56歲,p0.001)。孕期體重增長和孕前身體質(zhì)量指數(shù)(Body Mass Index,BMI),GDM組高于non-GDM組。與糖耐量正常的孕婦相比,GDM的孕婦學歷較低、孕次≥1、多產(chǎn)次和父母糖尿病史,且p0.05,差異有統(tǒng)計學意義。此外,孕早期血紅蛋白平均水平GDM組高于non-GDM組(123.66±8.23vs.121.01±7.97 g/L,p=0.003)。6.多因素邏輯回歸分析顯示:孕婦的年齡30~34歲組(OR=2.288,95%CI=1.163-4.499,p=0.016),年齡≥35歲組(OR=4.878,95%[CI]=2.379-10.000,p0.001),孕前體重指數(shù)(BMI)超重(OR=2.441,95%CI=1.782-3.344)或肥胖(OR=10.846,95%CI=6.003-19.597,p0.001),父親的糖尿病史(OR=2.543,95%CI=1.383-4.674,p=0.003)和母親糖尿病史(OR=3.598,95%CI=2.163-5.984,p0.001)。結論:此次調(diào)查發(fā)現(xiàn)二胎政策后黃島區(qū)GDM的患病率高達21.8%。GDM的獨立危險因素有高齡孕婦、孕前BMI超重/肥胖和一級親屬的糖尿病家族病史。我們發(fā)現(xiàn)GDM發(fā)生風險從30歲以后隨著母親年齡的遞增而顯著增高。母系糖尿病的遺傳傾向相比父系糖尿病與GDM發(fā)病更加密切。
[Abstract]:Objective: to investigate the prevalence and risk factors of gestational diabetes mellitus (GDM) in pregnant women in Huangdao District after the second trimester policy. Methods: cluster random sampling was used to select the Huangdao Hospital, the people's Hospital of the Development Zone and the Chinese Medicine Hospital of the Huangdao District, Qingdao University. From January 1 to July 31, 2016, the pregnant women with single pregnancy who received 75g-2h oral glucose tolerance test (oral glucose tolerance testOGTT) in three hospitals in Huangdao District of Qingdao were investigated and the data of clinical test were collected. A total of 4959 pregnant women were surveyed at least 4681 after calculating the sample size. The screening of gestational diabetes mellitus (gestational diabetes mellitusus) using the new diagnostic criteria of the International Diabetes Association and the pregnancy Research Organization (International Association of Diabetes and Pregnancy Study Group IADPSG: fasting blood glucose 鈮，

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