摘要
目的分析初孕妇妊娠糖尿病（GDM）与产后糖尿病（T2DM）发病因素,为筛查、管理GDM与产后T2DM,节省卫生资源,提高妊娠保健工作效用提供依据。方法筛选2012年5月-2014年5月到某院门诊以及分娩孕妇GDM患者185例纳入GDM组,按照年龄（±2年）、孕周（±1周）匹配,选取同期门诊、分娩未罹患GDM正常孕妇185例纳入非GDM组,进行问卷调查、跟踪随访。对罹患GDM孕产妇进行常规治疗干预,筛查产后T2DM。结果 GDM组年龄、受教育水平、家庭月净收入与非GDM组差异无统计学意义（P〉0.05）;DM家族史、孕前体重指数、孕期增重过多、孕期运动成为GDM发生独立风险因素,OR风险比分别为2.89、2.83、1.87、0.49;T2DM患者18例,T2GM组初次产检、末次产检、产后6~12周FPG水平高于转归对照组,末次产检、产后6~12周OGTT 2h水平高于转归对照组,T2GM组孕期血糖控制达标率低于转归对照组,差异均具有统计学意义（P〈0.05）。结论在排除年龄、孕周因素后,受教育水平并不是GDM影响因素;遗传、体质、孕期保健对GDM发生影响较显著;对确诊为GDM患者开展干预非常必要,干预效果直接影响G2TM发生风险。
Objective To make analysis on the pathogenic factors of gestationaldiabetes mellitus（ GMD） and postpartum diabetes in the first-time pregnant women,and thus to provide evidence to save health resources for the screening and management of GMD and postpartum diabetes as well as promote the effectiveness of pregnant health care work. Methods 185 GMD patients of a out-patient department of a hospital from May 2012 to May 2014 were selected as GDM group. Matching by age（ ± 2 year-old）,gestational week（ ± 1 week）,185 normal pregnant women during the same period in the same out-patient department were selected as Non-GMD group. They all received questionnaire survey and follow-up. Then GMD group received routine treatment as intervention and screening for postpartum diabetes. Results The differences of age,educational level and family monthly net income between GMD group and non-GMD grouphad no statistical significance（ P 〉 0. 05）. DM family history,pre-pregnant BMI,excessive weight gain during pregnancy and physical activity during pregnancy were independent risk factors for GDM,OR risk ration were 2. 89,2. 83,1. 87,0. 49 respectively. 18 cases of postpartum diabetes were identified in GMD group. Their FPG level at the first-time antenatal care,last-time antenatal care,6-12 weeks after delivery were higher than those of lapse-to control group. And their OGTT2 h level at the last antenatal care,6-12 weeks after delivery were higher than those of lapse-to control group. The up-to-standard rate for blood sugar control of postpartum diabetes group was lower than that of lapse-to control group and the differences were statistically significant（ P 〈 0. 05）.Conclusion After the controlling of age and gestational weeks,educational level was not the influencing factor. The impactsof heredity,physique and pregnant health care were more obvious on the onsetof GDM. It is quite necessary to conduct invention in GMD patients. And the intervention effect affected the onset risk of postpartum diabetes.
出处
《中国妇幼卫生杂志》
2015年第3期14-17,共4页
Chinese Journal of Women and Children Health
关键词
初孕
妊娠糖尿病
产后糖尿病
因素分析
the-fisrt time pregnancy
gestational diabetes mellitus
postpartum diabetes
factor analysis
