2011 年至 2017 年孕妇糖尿病的时间趋势及其与分娩结局的关系。
Temporal trend of diabetes in pregnant women and its association with birth outcomes, 2011 to 2017.
机构信息
Women's and Newborn Health, Westmead Hospital, Australia; University of New South Wales, Sydney, Australia; University of Sydney, Sydney, Australia.
University of New South Wales, Sydney, Australia; Agency for Clinical Innovation, NSW Health, Australia.
出版信息
J Diabetes Complications. 2020 Apr;34(4):107550. doi: 10.1016/j.jdiacomp.2020.107550. Epub 2020 Jan 24.
AIM
To assess changes in the prevalence of diabetes in pregnant women, and its association with selected birth outcomes (including caesarean section, episiotomy, admission to the special care nursery/neonatal intensive care unit, postpartum haemorrhage and neonatal birth weight) from 2011 to 2017.
METHODS
In a single-centre, retrospective cohort study, we examined records of pregnant women who attended an Australian tertiary hospital between 2011 and 2017, identifying women with gestational diabetes mellitus and pre-existing diabetes mellitus, and examined trends associated with diabetes and their effects on birth outcomes.
RESULTS
The average incidence of women with diabetes increased by 9% annually (RR = 0.09, 95% CI = 1.08-1.11), which was 6% greater in women who received antenatal doctor-led care (RR = 1.06, 95% CI = 1.01-1.13), 42% greater in women who had other endocrine diseases (including thyroid, adrenal or pituitary diseases) (RR = 1.42, 95% CI = 1.31-1.53), and 61% greater in women with hypertension during pregnancy (RR = 1.61, 95% CI = 1.47-1.78). The presence of diabetes did not affect the relative risks of caesarean section, episiotomy, postpartum haemorrhage, decreased neonatal birth weight or special care nursery/neonatal intensive care unit admission, after adjustment for demographics and health and care status and behaviours.
CONCLUSIONS
The rate of diabetes during pregnancy increased from 2011 to 2017. Diabetes did not affect the relative risk of untoward birth outcomes.
目的
评估 2011 年至 2017 年期间孕妇糖尿病患病率的变化及其与选定的分娩结局（包括剖宫产、会阴切开术、入住特级护理病房/新生儿重症监护病房、产后出血和新生儿出生体重）的关系。
方法
在一项单中心回顾性队列研究中，我们检查了 2011 年至 2017 年期间在澳大利亚一家三级医院就诊的孕妇记录，确定了患有妊娠糖尿病和既往糖尿病的孕妇，并检查了与糖尿病相关的趋势及其对分娩结局的影响。
结果
每年患有糖尿病的女性比例平均增加 9%（RR=0.09，95%CI=1.08-1.11），接受产前医生主导护理的女性增加 6%（RR=1.06，95%CI=1.01-1.13），患有其他内分泌疾病（包括甲状腺、肾上腺或垂体疾病）的女性增加 42%（RR=1.42，95%CI=1.31-1.53），患有妊娠高血压的女性增加 61%（RR=1.61，95%CI=1.47-1.78）。调整人口统计学、健康和护理状况以及行为因素后，糖尿病的存在并未影响剖宫产、会阴切开术、产后出血、新生儿出生体重降低或特级护理病房/新生儿重症监护病房入院的相对风险。
结论
从 2011 年到 2017 年，怀孕期间的糖尿病发病率有所增加。糖尿病并没有影响不良分娩结局的相对风险。
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