快速发展社区的妊娠糖尿病患病率及相关母婴并发症：全球比较。
Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons.
机构信息
Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar.
出版信息
Int J Womens Health. 2011;3:367-73. doi: 10.2147/IJWH.S26094. Epub 2011 Nov 7.
BACKGROUND
The prevalence of gestational diabetes (GDM) is increasing all over the world. Hence, the impact of GDM on maternal and infant health is an important topic of research. No study has been conducted in Qatar to evaluate the outcome of pregnancies complicated by diabetes mellitus.
OBJECTIVE
The aim of the study was to determine the prevalence of GDM, compare the maternal-neonatal complications among women with GDM and non-GDM pregnant women, and investigate the risk factors and potential outcomes associated with GDM.
DESIGN
This is a prospective cohort study.
SETTING
The survey was carried out at the antenatal clinics of the Women's Hospital, Qatar.
SUBJECTS AND METHODS
A representative sample of 2056 pregnant women who attended the antenatal clinics of the Women's Hospital were surveyed during the period from the first week of January 2010 to April 2011. From this sample, 1608 women (78.2%) expressed their consent to participate in the study. Questionnaires were administered to pregnant women who were seeking antenatal care at this urban hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome.
RESULTS
The prevalence of GDM in Qatar was 16.3%. Women with GDM were significantly higher in the age group of 35-45 years (45%; P = 0.001). Family history of diabetes (31.7%; P < 0.001), increased parity (55.3%; P = 0.004), and obesity (59.2%; P < 0.001) were determinants of GDM in pregnant women. Maternal complications like pregnancy-induced hypertension (19.1% vs 10.3%; P < 0.001), pre-eclampsia (7.3% vs 3.8%; P = 0.012), antepartum hemorrhage (19.2% vs 14.6%; P = 0.05), and cesarean (27.9% vs 12.4%; P < 0.001) were significantly higher in GDM women. Neonates were at increased risk of preterm birth (12.6% vs 8.3%; P = 0.03), macrosomia (10.3% vs 5.9%; P = 0.01), and birth trauma (8% vs 3%; P < 0.001).
CONCLUSION
The study findings revealed that GDM was higher in women in Qatar and that they were at increased risk of developing maternal and neonatal complications. Obesity emerged as an essential risk factor for subsequent GDM. The advanced maternal age, low monthly income, family history of diabetes, and obesity were the main significant risk factors for GDM.
背景
妊娠糖尿病（GDM）的患病率在全球范围内呈上升趋势。因此，GDM 对母婴健康的影响是一个重要的研究课题。卡塔尔尚未开展评估糖尿病合并妊娠结局的研究。
目的
本研究旨在确定 GDM 的患病率，比较 GDM 孕妇与非 GDM 孕妇的母婴并发症，并探讨与 GDM 相关的危险因素和潜在结局。
设计
这是一项前瞻性队列研究。
地点
在卡塔尔妇女医院的产前诊所进行调查。
对象和方法
2010 年 1 月第一周至 2011 年 4 月期间，对在该妇女医院产前诊所就诊的 2056 名孕妇进行了一项代表性抽样调查。从该样本中，有 1608 名（78.2%）孕妇表示同意参与研究。对在这家城市医院寻求产前护理的孕妇进行问卷调查。问卷涵盖了与社会人口统计学因素、家族史、病史、产妇并发症和新生儿结局相关的变量。
结果
卡塔尔的 GDM 患病率为 16.3%。35-45 岁年龄组的 GDM 孕妇比例显著更高（45%；P=0.001）。糖尿病家族史（31.7%；P<0.001）、多胎妊娠（55.3%；P=0.004）和肥胖（59.2%；P<0.001）是孕妇 GDM 的决定因素。GDM 孕妇的母婴并发症发生率较高，包括妊娠高血压（19.1%比 10.3%；P<0.001）、子痫前期（7.3%比 3.8%；P=0.012）、产前出血（19.2%比 14.6%；P=0.05）和剖宫产（27.9%比 12.4%；P<0.001）。GDM 新生儿早产（12.6%比 8.3%；P=0.03）、巨大儿（10.3%比 5.9%；P=0.01）和出生创伤（8%比 3%；P<0.001）的风险增加。
结论
研究结果表明，卡塔尔的 GDM 患病率较高，孕妇发生母婴并发症的风险增加。肥胖是随后发生 GDM 的重要危险因素。高龄、低月收入、糖尿病家族史和肥胖是 GDM 的主要显著危险因素。
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