妊娠期糖尿病患者發(fā)病及不良妊娠結(jié)局的影響因素分析
發(fā)布時間：2018-09-18 14:09
【摘要】：目的本研究通過病例對照研究,探討妊娠期糖尿病(GDM)發(fā)病的影響因素,分析GDM發(fā)生不良結(jié)局的影響因素,以期為更好地防治GDM的發(fā)生、提高母嬰健康水平提供依據(jù)。方法本資料來源于2013年1月~2015年3月于華北理工大學(xué)附屬醫(yī)院婦產(chǎn)科門診產(chǎn)前保健并住院分娩的診斷為GDM的孕產(chǎn)婦168例,合并再入院重復(fù)病例6例,剔除未在我院治療并住院分娩無妊娠結(jié)局指標(biāo)5例、病歷資料不完全7例,最終納入本研究的GDM組150例,同期150例糖耐量正常孕產(chǎn)婦為正常組。為了研究GDM發(fā)生不良妊娠結(jié)局的影響因素,將GDM組分為不良妊娠結(jié)局組和未發(fā)生不良結(jié)局組。孕婦的一般信息、臨床資料和妊娠結(jié)局通過填寫調(diào)查問卷和采集住院病案信息的方式進(jìn)行錄入分析,所有數(shù)據(jù)采用SPSS 20.0軟件進(jìn)行統(tǒng)計學(xué)分析。單因素分析中,兩組年齡、孕產(chǎn)次、體重指標(biāo)等計量資料采用獨立樣本t檢驗,用x±s表示。職業(yè)、居住地、糖尿病家族史等計數(shù)資料采用χ2檢驗,用百分率表示。多因素分析采用多因素非條件logistic回歸分析。結(jié)果1 GDM組與正常組對比,單因素分析中年齡、孕前BMI、文化程度、糖尿病家族史和不良孕產(chǎn)史等比較,差異有統(tǒng)計學(xué)意義(P0.05);多因素logistic回歸分析中年齡[OR=3.137,95%CI(1.103,8.920)]、孕前BMI[OR=3.100,95%CI(1.701,5.651)]、糖尿病家族史[OR=2.524,95%CI(1.091,5.838)]和不良孕產(chǎn)史[OR=3.468,95%CI(1.196,10.058)]的結(jié)果有統(tǒng)計學(xué)意義(P0.05)。GDM組子癇前期、剖宮產(chǎn)和巨大兒的發(fā)生率高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。2發(fā)生不良結(jié)局組與未發(fā)生不良結(jié)局組對比,單因素分析中孕前BMI、確診時BMI、OGTT空腹血糖、FINS和HOMA-IR等比較,差異有統(tǒng)計學(xué)意義(P0.05),多因素logistic回歸分析中孕前BMI[OR=1.500,95%CI(1.132,1.988)]和OGTT空腹血糖[OR=2.078,95%CI(1.020,4.233)]的結(jié)果有統(tǒng)計學(xué)意義(P0.05)。結(jié)論1年齡≥35歲、孕前BMI≥24.0kg/m2、有糖尿病家族史和不良孕產(chǎn)史是GDM發(fā)病的危險因素,具有以上因素的孕婦發(fā)生GDM的風(fēng)險升高。2 GDM孕婦發(fā)生子癇前期和巨大兒的風(fēng)險顯著高于正常孕婦,并且剖宮產(chǎn)手術(shù)率也明顯升高。3 GDM孕婦的75g OGTT空腹血糖升高和孕前BMI增加是GDM孕婦發(fā)生不良妊娠結(jié)局的危險因素。
[Abstract]:Objective to investigate the influencing factors of (GDM) in gestational diabetes mellitus (GDM) by case-control study, and to analyze the influencing factors of adverse outcome of GDM in order to provide evidence for better prevention and treatment of GDM and improvement of maternal and child health. Methods from January 2013 to March 2015, 168 pregnant and parturient women who were diagnosed as GDM in the outpatient department of obstetrics and gynecology of affiliated Hospital of North China University of Science and Technology were diagnosed as GDM, and 6 cases were re-admitted. Five cases without pregnancy outcome index and 7 cases with incomplete medical records were excluded. 150 cases of GDM group were included in this study, and 150 cases of normal pregnant women with normal glucose tolerance in the same period were included in this study. In order to study the influencing factors of adverse pregnancy outcome in GDM, the GDM group was divided into bad pregnancy outcome group and no adverse pregnancy outcome group. The general information, clinical data and pregnancy outcome of pregnant women were recorded and analyzed by filling out questionnaires and collecting the information of medical records in hospital. All the data were analyzed statistically by SPSS 20.0 software. In univariate analysis, two groups of measurement data, such as age, pregnancy, weight index, were measured by independent sample t test, expressed by x 鹵s. The data of occupation, residence and family history of diabetes were measured by 蠂 2 test and expressed as percentage. Multivariate logistic regression analysis was used. Results 1Comparison between GDM group and normal group, age, pre-pregnancy BMI, education, diabetic family history and bad pregnancy history were compared in univariate analysis. There were significant differences in age [OR=3.137,95%CI (1.103 鹵8.920)], BMI before pregnancy [OR=3.100,95%CI (1.701 鹵5.651)], family history of diabetes [OR=2.524,95%CI (1.091 鹵5.838)] and adverse maternal history [OR=3.468,95%CI (1.196 10.058)] in multivariate logistic regression analysis (P0.05). The incidence of cesarean section and macrosomia was significantly higher in GDM group than in control group (P0.05). The difference was statistically significant (P0.05). 2 there were significant differences between the group with bad outcome and the group with no adverse outcome. In univariate analysis, the fasting blood glucose levels of BMI,OGTT, fins and HOMA-IR were compared during the diagnosis of BMI, before pregnancy. The difference was statistically significant (P0.05). The results of BMI [OR=1.500,95%CI (1.132 鹵1.988)] before pregnancy and fasting blood glucose (OR=2.078,95%CI (1.020 鹵4.233) in multivariate logistic regression analysis were statistically significant (P0.05). Conclusion 1Age 鈮，
本文編號：2248157
[Abstract]:Objective to investigate the influencing factors of (GDM) in gestational diabetes mellitus (GDM) by case-control study, and to analyze the influencing factors of adverse outcome of GDM in order to provide evidence for better prevention and treatment of GDM and improvement of maternal and child health. Methods from January 2013 to March 2015, 168 pregnant and parturient women who were diagnosed as GDM in the outpatient department of obstetrics and gynecology of affiliated Hospital of North China University of Science and Technology were diagnosed as GDM, and 6 cases were re-admitted. Five cases without pregnancy outcome index and 7 cases with incomplete medical records were excluded. 150 cases of GDM group were included in this study, and 150 cases of normal pregnant women with normal glucose tolerance in the same period were included in this study. In order to study the influencing factors of adverse pregnancy outcome in GDM, the GDM group was divided into bad pregnancy outcome group and no adverse pregnancy outcome group. The general information, clinical data and pregnancy outcome of pregnant women were recorded and analyzed by filling out questionnaires and collecting the information of medical records in hospital. All the data were analyzed statistically by SPSS 20.0 software. In univariate analysis, two groups of measurement data, such as age, pregnancy, weight index, were measured by independent sample t test, expressed by x 鹵s. The data of occupation, residence and family history of diabetes were measured by 蠂 2 test and expressed as percentage. Multivariate logistic regression analysis was used. Results 1Comparison between GDM group and normal group, age, pre-pregnancy BMI, education, diabetic family history and bad pregnancy history were compared in univariate analysis. There were significant differences in age [OR=3.137,95%CI (1.103 鹵8.920)], BMI before pregnancy [OR=3.100,95%CI (1.701 鹵5.651)], family history of diabetes [OR=2.524,95%CI (1.091 鹵5.838)] and adverse maternal history [OR=3.468,95%CI (1.196 10.058)] in multivariate logistic regression analysis (P0.05). The incidence of cesarean section and macrosomia was significantly higher in GDM group than in control group (P0.05). The difference was statistically significant (P0.05). 2 there were significant differences between the group with bad outcome and the group with no adverse outcome. In univariate analysis, the fasting blood glucose levels of BMI,OGTT, fins and HOMA-IR were compared during the diagnosis of BMI, before pregnancy. The difference was statistically significant (P0.05). The results of BMI [OR=1.500,95%CI (1.132 鹵1.988)] before pregnancy and fasting blood glucose (OR=2.078,95%CI (1.020 鹵4.233) in multivariate logistic regression analysis were statistically significant (P0.05). Conclusion 1Age 鈮，
本文編號：2248157
本文鏈接：http://sikaile.net/yixuelunwen/fuchankeerkelunwen/2248157.html
最近更新
教材專著
