Fan Yanfeng, Xu Rongxian, Cai Lili, Cai Liqian
Maternal and Child Health Hospital, Xiamen 361003, China.
Wei Sheng Yan Jiu. 2017 Nov;46(6):925-929.
To discuss the risk factors of the gestational diabetes mellitus( GDM) among the re-birth pregnant women.
A total of 393 pregnant women with GDM were collected randomly according to the number of the antenatal care manual in the Maternal and Child Health Hospital in Xiamen City. Meanwhile, 393 pregnant women with normal glucose tolerance were chosen to be the control group matching withage of the GDM group. Their basic data would be analyzed, including the BMI before pregnancy, the degree of the education, the times of the abortion, the body weight gain during the pregnancy, their parental diabetes history, the birth weight of the last fetal, the history of GDM and so on. The two groups of people were re-birth pregnant women.
Single factor analysis showed that among the GDM group, the total body weight gain before the 24 th week( 9. 11 ± 3. 09) kg and the proportion of their mothers with the DM( 64/393) were both higher than the control group( 7. 54 ± 2. 95) kg and( 38/393), however, the degree of the education was lower than the control group. Paired chi-square analysis showed that the history of macrosomia delivery( χ2= 14. 297, P = 0. 001), the history of GDM( χ2= 12. 938, P = 0. 001), and abortion history more than 2 times( χ~2=7. 078, P = 0. 010) were the risk factors of GDM for those women. Meanwhile, with the increasing of the fetal birth weight, the risk of being the GDM during the second pregnancy was also increasing. When the fetal birth weight reached 3. 8 kg, OR = 3. 467, the risk value reached a strong correlation. Multiple factors Logistic regression analysis showed those factors of GDM also had statistically significant differences, especially the bodyweight gain before the 24 th week over 10 kg played the most important role during the pregnancy( OR = 1. 875, P = 0. 001).
The risk factors of the GDM for the re-birth pregnant women concluded the history of GDM, the history of macrosomia, the times of the abortion over twice, the bodyweight gain before the 24 th week over 10 kg, the low degree of the education, the pregnant women 's mother had the DM. For those pregnant women with fetal birth weight above 3. 8 kg, they should be included in the high risk population of GDM during the next pregnancy.
探讨再次妊娠孕妇妊娠期糖尿病（GDM）的危险因素。
按照厦门市妇幼保健院产前检查手册编号，随机收集393例GDM孕妇。同时，选取393例糖耐量正常孕妇作为对照组，与GDM组进行年龄匹配。分析她们的基础资料，包括孕前体重指数、学历程度、流产次数、孕期体重增加量、父母糖尿病史、上次胎儿出生体重、GDM病史等。两组均为再次妊娠孕妇。
单因素分析显示，GDM组孕24周前总体重增加量（9.11±3.09）kg及母亲患糖尿病的比例（64/393）均高于对照组（7.54±2.95）kg及（38/393），但其学历程度低于对照组。配对卡方分析显示，巨大儿分娩史（χ²=14.297，P=0.001）、GDM病史（χ²=12.938，P=0.001）及流产史超过2次（χ²=7.078，P=0.010）是这些女性发生GDM的危险因素。同时，随着胎儿出生体重增加，再次妊娠时发生GDM的风险也增加。当胎儿出生体重达到3.8 kg时，OR=3.467，风险值达到强相关。多因素Logistic回归分析显示，这些GDM相关因素也有统计学差异，尤其是孕24周前体重增加超过10 kg在孕期起最重要作用（OR=1.875，P=0.001）。
再次妊娠孕妇发生GDM的危险因素包括GDM病史、巨大儿病史、流产次数超过2次、孕24周前体重增加超过10 kg、学历程度低、孕妇母亲患糖尿病。对于胎儿出生体重超过3.8 kg的孕妇，下次妊娠时应纳入GDM高危人群。
