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目的对四川广元地区2012至2013年妊娠期糖尿病(GDM)发病情况进行分析,为提高GDM筛查和管理水平建立预防策略。方法收集四川省广元市2012年1月至2013年12月采用75g葡萄糖糖耐量筛查的10 973例孕妇的临床资料,分析GDM的发病率、危险因素及对妊娠结局的影响。结果 10 973例孕产妇共发现GDM患者201例,GDM发病率为1.83%。年龄、喜食甜食、家庭月收入、家族糖尿病史情况不同,患者GDM发病率差异有统计学意义(x~2值分别为8.678、39.778、22.321、59.773,均P<0.05)。进行多因素分析发现,年龄大于30岁,家庭月收入低于3 000元,有家族糖尿病史,喜食甜食等4项是GDM发生的高危因素(均P<0.05)。GDM患者剖宫产比例、妊娠期其他并发症及合并症发病率、新生儿并发症发生率、转新生儿科比例均高于非GDM产妇(x~2值分别为14.899、124.250、21.782和8.667,均P<0.05)。结论 GDM发病率与患者家庭条件、家族糖尿病史、饮食习惯、年龄等有着密切的关系,应在妊娠早期进行建档管理,以预防GDM的发生和改善母婴结局。
Objective To analyze the incidence of gestational diabetes mellitus (GDM) from 2012 to 2013 in Guangyuan, Sichuan Province, and to establish a preventive strategy to improve the screening and management of GDM. Methods The clinical data of 10 973 pregnant women who were screened by glucoseglucose 75g from January 2012 to December 2013 in Guangyuan City of Sichuan Province were collected to analyze the incidence of GDM, the risk factors and the effect on pregnancy outcome. Results Among 10 973 pregnant women, 201 cases of GDM were found, the incidence of GDM was 1.83%. Age, eating sweet, family monthly income, family history of diabetes are different, the incidence of GDM patients was statistically significant (x ~ 2 values were 8.678,39.778,22.321,59.773, all P <0.05). According to multivariate analysis, there were 4 risk factors of GDM (age, 30 years old, family monthly income less than 3 000 yuan, history of family history of diabetes and eating sweets) (all P <0.05). The proportion of cesarean section, the incidence of other complications and complications during pregnancy, the incidence of neonatal complications and neonatal transfer in GDM patients were higher than those of non-GDM mothers (x ~ 2 = 14.899, 124.250, 21.782 and 8.667, All P <0.05). Conclusions The incidence of GDM is closely related to family conditions, family history of diabetes, dietary habits, age and so on. It should be managed in the first trimester to prevent the occurrence of GDM and improve the maternal and infant outcome.