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目的探讨温岭地区影响妊娠期糖尿病(GDM)发生的危险因素,为制定该地区孕妇早期防治该病的措施提供理论依据。方法选择温岭地区1 658名孕妇为研究对象,进行问卷调查及GDM筛查,并采用Logistic回归方法进行分析影响GDM发生的危险因素。结果温岭地区1 658名孕妇中有85例发生GDM,发病率为5.1%。单因素分析显示,高龄(>35岁)、产次(≥1次)、孕前BMI≥25 kg/m2、既往有不良孕产史、有糖尿病家族史、孕早期Hb>130 g/L、C反应蛋白增高者的GDM发生率明显高于年龄(<35岁)、产次(0次)、孕前BMI<25 kg/m2、既往无不良孕产史、无糖尿病家族史、孕早期Hb<130 g/L、C反应蛋白正常者。多因素分析结果显示孕前BMI≥25 kg/m2、既往不良孕产史、糖尿病家族史、C反应蛋白增高及孕早期Hb>130 g/L是影响GDM发生的独立危险因素。结论对具有高危因素的孕妇应及时进行血糖筛查,早发现、早诊断GDM,给予积极的预防措施,以降低高危孕妇中GDM的发生风险,确保母婴健康。
Objective To explore the risk factors that affect the occurrence of gestational diabetes mellitus (GDM) in Wenling area and provide a theoretical basis for the development of pregnant women in this area. Methods A total of 1 658 pregnant women in Wenling district were selected as the study subjects. Questionnaires and GDM screening were conducted. Logistic regression was used to analyze the risk factors affecting the occurrence of GDM. Results 85% of 1 658 pregnant women in Wenling developed GDM with a prevalence of 5.1%. Univariate analysis showed that older (35 years old), parity (≥1 times), pre-pregnancy BMI≥25 kg / m2, history of adverse pregnancy history, family history of diabetes, Hb> 130 g / L during the first trimester, The incidence of GDM was significantly higher than that of the age (<35 years), parity (0), BMI <25 kg / m2 before pregnancy, no history of adverse pregnancy, no family history of diabetes, Hb <130 g / L, normal C-reactive protein. Multivariate analysis showed that pre-pregnancy BMI≥25 kg / m2, previous adverse pregnancy history, family history of diabetes, elevated C-reactive protein and Hb> 130 g / L in early pregnancy were independent risk factors for GDM. Conclusion Pregnant women with high risk factors should be promptly carried out blood glucose screening, early detection and early diagnosis of GDM, and give positive precautions to reduce the risk of GDM in high-risk pregnant women to ensure the health of mothers and infants.