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北京妊娠期糖尿病的高患病率:母亲出生体重及其他危险因素的影响

High Prevalence of Gestational Diabetes Mellitus in Beijing: Effect of Maternal Birth Weight and Other Risk Factors.

作者信息

Zhu Wei-Wei, Yang Hui-Xia, Wang Chen, Su Ri-Na, Feng Hui, Kapur Anil

机构信息

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034; Exchange and Cooperation Division, National Institute of Hospital Administration, Beijing 100191, China.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

出版信息

Chin Med J (Engl). 2017 May 5;130(9):1019-1025. doi: 10.4103/0366-6999.204930.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is associated with both short- and long-term adverse health consequences for both the mother and her offspring. The aim was to study the prevalence and risk factors for GDM in Beijing.

METHODS

The study population consisted of 15,194 pregnant women attending prenatal care in 15 hospitals in Beijing, who delivered between June 20, 2013, and November 30, 2013, after 28 weeks of gestation. The participants were selected by cluster sampling from the 15 hospitals identified through random systematic sampling based on the number of deliveries in 2012. A questionnaire was designed to collect information.

RESULTS

A total of 2987 (19.7%) women were diagnosed with GDM and 208 (1.4%) had diabetes in pregnancy (DIP). Age (OR: 1.053, 95% CI: 1.033-1.074, P < 0.01), family history of diabetes mellitus (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), prepregnancy body mass index (BMI) (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), BMI gain before 24 weeks (OR: 1.126, 95% CI: 1.075-1.800, P < 0.01), maternal birth weight (P < 0.01), and fasting plasma glucose at the first prenatal visit (P < 0.01) were identified as risk factors for GDM. In women with birth weight <3000 g, GDM rate was significantly higher.

CONCLUSIONS

One out of every five pregnant women in Beijing either had GDM or DIP and this constitutes a huge health burden for health services. Prepregnancy BMI and weight gain before 24th week are important modifiable risk factors for GDM. Ensuring birth weight above 3000 g may help reduce risk for future GDM among female offsprings.

摘要

背景

妊娠期糖尿病(GDM)与母亲及其后代的短期和长期不良健康后果相关。目的是研究北京地区GDM的患病率及危险因素。

方法

研究人群包括2013年6月20日至2013年11月30日期间在北京市15家医院接受产前检查、妊娠28周后分娩的15194名孕妇。通过基于2012年分娩数量的随机系统抽样确定这15家医院,再从这些医院中采用整群抽样的方法选取研究对象。设计了一份问卷来收集信息。

结果

共有2987名(19.7%)女性被诊断为GDM,208名(1.4%)患有妊娠糖尿病(DIP)。年龄(比值比:1.053,95%可信区间:1.033 - 1.074,P < 0.01)、糖尿病家族史(比值比:1.481,95%可信区间:1.254 - 1.748,P < 0.01)、孕前体重指数(BMI)(比值比:1.481,95%可信区间:1.254 - 1.748,P < 0.01)、孕24周前体重增加量(比值比:1.126,95%可信区间:1.075 - 1.800,P < 0.01)、母亲出生体重(P < 0.01)以及首次产前检查时的空腹血糖(P < 0.01)被确定为GDM的危险因素。出生体重<3000 g的女性中,GDM发生率显著更高。

结论

北京地区每五名孕妇中就有一人患有GDM或DIP,这给医疗服务带来了巨大的健康负担。孕前BMI和孕24周前体重增加是GDM重要的可改变危险因素。确保出生体重高于3000 g可能有助于降低女性后代未来患GDM的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c56/5421170/a2270271d305/CMJ-130-1019-g001.jpg

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