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中国孕妇妊娠糖尿病的危险因素:一项对中国 16286 名孕妇的前瞻性研究。

Risk factors for gestational diabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China.

机构信息

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

出版信息

Diabet Med. 2009 Nov;26(11):1099-104. doi: 10.1111/j.1464-5491.2009.02845.x.

Abstract

AIMS

To determine the incidence of gestational diabetes mellitus (GDM) in China and to further identify population specific risk factors for GDM.

METHODS

Following a universal GDM screening recommendation, 16,286 pregnant women who underwent a 50-g glucose challenge test from 18 cities in China were followed up through pregnancy. GDM was confirmed by oral glucose tolerance test according to American Diabetes Association criteria.

RESULTS

The incidence of GDM was 4.3%. Previously reported risk factors for GDM, including advanced maternal age, pre-pregnancy obesity and family history of diabetes, were strongly associated with an elevated GDM risk. Moreover, after the adjustment for the above-mentioned risk factors, a history of recurrent vulvovaginal candidiasis, residency in south China and a history of spontaneous abortion were significantly associated with an increased GDM risk; adjusted odds ratio (OR) [95% confidence interval (95% CI)] were 1.97 (1.39, 2.80), 1.84 (1.59-2.13), and 1.46 (1.12, 1.91), respectively.

CONCLUSIONS

In this large study of GDM in Chinese women, advanced maternal age, pre-pregnancy overweight or obesity and family history of diabetes were confirmed to be risk factors. In addition, a history of recurrent vulvovaginal candidiasis or spontaneous abortion and residency in south China appeared to be novel risk factors in this population.

摘要

目的

确定中国妊娠期糖尿病(GDM)的发病率,并进一步确定 GDM 的特定人群危险因素。

方法

根据普遍的 GDM 筛查建议,对来自中国 18 个城市的 16286 名接受 50g 葡萄糖挑战试验的孕妇进行了随访。根据美国糖尿病协会的标准,通过口服葡萄糖耐量试验来确诊 GDM。

结果

GDM 的发病率为 4.3%。先前报道的 GDM 危险因素,包括高龄产妇、孕前肥胖和糖尿病家族史,与 GDM 风险增加密切相关。此外,在调整了上述危险因素后,复发性外阴阴道念珠菌病史、居住在华南地区和自然流产史与 GDM 风险增加显著相关;调整后的优势比(OR)[95%置信区间(95%CI)]分别为 1.97(1.39,2.80)、1.84(1.59-2.13)和 1.46(1.12,1.91)。

结论

在这项针对中国女性 GDM 的大型研究中,高龄产妇、孕前超重或肥胖以及糖尿病家族史被证实是危险因素。此外,复发性外阴阴道念珠菌病史或自然流产史以及居住在华南地区似乎是该人群的新危险因素。

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