摘要
目的探究妊娠期糖尿病(GDM)患者早孕期身体质量指数(BMI)增幅和24 h内葡萄糖在目标范围内时间与围产结局之间的关系。方法回顾性分析2019年10月至2021年10月期间,郑州市金水区总医院收治的妊娠期糖尿病患者共计188例,全部研究对象均在妊娠期早期接受体BMI、血糖水平的定期监测;查阅患者病历资料,根据围产结局将全部研究对象划分为顺利妊娠组(n=123)以及不良结局组(n=65);收集患者一般资料信息,记录孕早期BMI增幅、空腹血糖(FBG)、24 h内葡萄糖在目标范围内时间、糖化血红蛋白(HbA1c)水平。首先采用单因素Logistic回归分析探究可能影响妊娠期糖尿病者围产结局的相关因素,随后将组间差异存在统计学意义的因素纳入Logistic多因素分析,并探究引发GDM患者不良围产结局的独立危险因素。结果单因素回归分析结果显示,不良结局组产妇存在妊娠合并高血压、GDM家族史的病例数占比高于顺利妊娠组,差异有统计学意义(P<0.05);另外,不良结局组产妇的母血乳酸、孕早期BMI指数增幅、FBG以及HbA1c水平显著高于顺利妊娠组产妇、葡萄糖在目标范围内时间低于顺利妊娠组产妇,差异有统计学意义(P<0.05);多因素回归分析结果显示,早孕期BMI增幅偏高、孕妇FBG、HbA1c水平偏高、葡萄糖在目标范围内时间偏低是造成GDM产妇不良围产结局的独立危险因素,差异有统计学意义(P<0.05)。结论GDM患者孕早期BMI增幅以及葡萄糖水平在目标范围时间内与围产结局存在显著的相关性,BMI增幅偏高、葡萄糖在目标范围内时间偏低、空腹血糖以及糖化血红蛋白偏高是造成GDM产妇不良围产结局的独立危险因素。
Objective To explore the relationship between the increase of body mass index(BMI)in early pregnancy,the time of glucose in the target range within 24 hours and perinatal outcomes in patients with gestational diabetes mellitus(GDM).Methods From October 2019 to October 2021,a total of 188 patients with GDM who were admitted to the General Hospital of Jinshui District,Zhengzhou City,were retrospectively analyzed.All the subjects received regular monitoring of BMI and blood glucose levels in the early stage of pregnancy;Patients'medical records were consulted and all subjects were divided into two groups according to perinatal outcomes:smooth pregnancy group(n=123)and adverse outcome group(n=65);General information of patients was collected,and BMI increase,fasting blood glucose(FBG),glucose in the target range within 24 hours,and glycated hemoglobin(HbA1c)were recorded during early pregnancy.Single factor Logistic regression analysis was used to explore the related factors that might affect the perinatal outcomes of GDM patients,and then the factors with statistical significance between groups were included in the Logistic multivariate analysis to explore the independent risk factors of adverse perinatal outcomes in patients with GDM.Results The results of univariate regression analysis showed that the proportion of cases with pregnancy complicated hypertension and GDM family history in the adverse outcome group was higher than that in the smooth pregnancy group,and the difference was statistically significant(P<0.05);In addition,the maternal blood lactate,early pregnancy BMI index increase,FBG,and HbA1c levels in the adverse outcome group were significantly higher than those in the smooth pregnancy group,and the glucose within the target range was lower than that in the smooth pregnancy group,the difference was statistically significant(P<0.05);The results of multiple regression analysis showed that high increase in BMI during early pregnancy,high levels of FBG and HbA1c in pregnant women,and low duration of glucose within the target range were independent risk factors for adverse perinatal outcomes in GDM mothers(P<0.05).Conclusion There is a significant correlation between early pregnancy BMI increase and glucose levels in GDM patients and perinatal outcomes within the target time range.High BMI increase,low glucose within the target time range,high fasting blood glucose and glycated hemoglobin are independent risk factors for adverse perinatal outcomes in GDM women.
作者
杜晶晶
韩丽培
张小艳
DU Jingjing;HAN Lipei;ZHANG Xiaoyan(Obstetrics and Gynecology Department,Jinshui District General Hospital,Zhengzhou Henan 450000,China;Ultrasound Department,Jinshui District General Hospital,Zhengzhou Henan 450000,China;Ultrasound Room,Jinshui District General Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2024年第3期41-44,共4页
Clinical Research
关键词
妊娠期糖尿病
早孕期
体质量指数
葡萄糖水平
围产结局
gestational diabetes mellitus
early pregnancy
body mass index
glucose levels
perinatal outcome
作者简介
杜晶晶,女,主治医师,本科。研究方向:妊娠期糖尿病;通讯作者:张小艳,副主任医师,575739344@qq.com。
