摘要
目的了解妊娠期糖尿病(gestational diabetes mellitus,GDM)与不良结局的关系,为改善母婴结局提供依据。方法选取2018—2021年北京某地区分娩的6140例单胎产妇为研究对象,收集北京市妇幼保健信息系统中相关围产资料。按照是否患有GDM分为两组,即GDM组与非GDM组,比较两组孕产妇妊娠期并发症及不良结局的发生情况,并分析GDM对妊娠不良结局的影响。结果本研究中GDM组1191例,非GDM组4949例;两组孕产妇的户口、学历、年龄、孕前体质指数、分娩孕周、孕产次差异均有统计学意义(均P<0.05)。两组孕产妇孕期合并症和并发症发生情况结果显示,GDM组中流产≥3次、羊水过少、妊娠高血压、瘢痕子宫发生率分别为4.5%、4.2%、6.0%、22.8%,与非GDM组比较,差异均有统计学意义(χ^(2)=6.05、9.53、19.38、32.45,均P<0.05)。两组孕产妇不良分娩结局发生情况结果显示,GDM组中剖宫产、早产、低出生体重和巨大儿发生率分别为49.9%、7.6%、12.1%,与非GDM组比较,差异均有统计学意义(χ^(2)=23.16、17.84、10.73,均P<0.05)。多因素分析结果显示,GDM是早产(OR=1.35,95%CI:1.04~1.75)、低出生体重或巨大儿(OR=1.27,95%CI:1.03~1.56)的危险因素。结论GDM更容易引起早产、低出生体重、巨大儿等妊娠不良结局,应做好孕前健康教育和孕中的早发现、早干预,降低GDM的发病率,改善母婴结局。
Objective To investigate the association between gestational diabetes mellitus(GDM)and adverse pregnancy outcomes so as to provide reference for promoting the outcomes of maternal and infant.Methods Totally 6140 pregnant women who gave single birth in a certain area of Beijing from 2018 to 2021 were recruited as study subjects.Their perinatal data within the maternal and child health information system of Beijing were collected.They were divided into GDM group and non-GDM group according to their disease status.The incidence of pregnancy complications and adverse outcomes were compared between two groups,and the influence of GDM on the adverse outcomes of pregnancy were analyzed.Results There were 1191 cases in GDM group and 4949 cases in non-GDM group involved in the study.There were significant differences between two groups in terms of household registration,education background,age,BMI pre-pregnancy,gestational weeks,and parity(P<0.05).The incidence of abortion≥3 times,hypamnios,pregancy-induced hypertension and scar uterus in the GDM group were 4.5%,4.2%,6.0%and 22.8%,respectively,which were significantly different from those in non-GDM group(χ^(2)=6.05,9.53,19.38,32.45,all P<0.05).The incidence of cesarean section,premature delivery,low birth weight and macrosomia in GDM group were 49.9%,7.6%and 12.1%,respectively,which were significantly different from those in non-GDM group(χ^(2)=23.16,17.84,10.73,all P<0.05).Multivariate analysis showed that GDM was a risk factors for preterm delivery(OR=1.35,95%CI:1.04-1.75),low birthweight or macrcsomia(OR=1.27,95%CI:1.03-1.56).Conclusion GDM is more likely to cause adverse pregnancy outcomes such as preterm delivery,low birthweight or macrcsomia.Health education before pregnancy should be developed,early detection and intervention during pregnancy should be implemented to reduce the incidence of GDM and improve maternal and infant outcomes.
作者
岳爱花
张蕊
周敏
YUE Ai Hua;ZHANG Rui;ZHOU Min(South Area of Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102618,China)
出处
《中国妇幼卫生杂志》
2023年第1期7-11,共5页
Chinese Journal of Women and Children Health
