在新山产后六周进行口服葡萄糖耐量试验且葡萄糖耐量异常的有妊娠期糖尿病病史的女性比例。
Proportion of women with history of gestational diabetes mellitus who performed an oral glucose test at six weeks postpartum in Johor Bahru with abnormal glucose tolerance.
作者信息
Fatin Aab, Alina T I
机构信息
MD, MPH Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Email:
MD, MCM Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia.
出版信息
Malays Fam Physician. 2019 Dec 31;14(3):2-9. eCollection 2019.
INTRODUCTION
Glucose testing at six weeks postpartum has been recommended by the World Health Organization as the earliest period in which to detect abnormal glucose tolerance among women with a history of gestational diabetes mellitus (GDM). This study aimed to determine the outcomes of six weeks postpartum glucose testing and its associated factors among women with a history GDM who attended government primary health clinics in Johor Bahru.
METHODS
The study was a cross sectional study which was conducted among women with a history of GDM who registered from January to June 2016 at primary health clinics in Johor Bahru and underwent an oral glucose tolerance test at six weeks postpartum. Secondary data were obtained from Maternal Health Records (clinic copy). Data were analyzed using SPSS Version 23.0. Descriptive statistics and simple logistic regression analysis were used.
RESULTS
One hundred and twenty-two women with a history of GDM completed the postpartum glucose testing. Approximately 12% of these women were reported to have abnormal glucose tolerance. Insulin usage (OR:5.44; 95% CI:1.53, 19.43; p=0.009), abnormal glycated hemoglobin (OR:8.70; 95% CI:2.68,26.27; p<0.01), hospital follow-up (OR:3.38; 95% CI: 1.11, 10.34; p=0.033) and neonatal intensive care unit admission (OR:3.96; 95% CI: 1.16, 13.54; p=0.028) were found to have significant associations with abnormal glucose tolerance at six weeks postpartum. The proportion of women with a history of GDM and abnormal glucose tolerance at six weeks postpartum in Johor Bahru was 12% and was associated with insulin usage, abnormal glycated hemoglobin, hospital follow-up and neonatal intensive care unit admission. Screening during the postpartum period offers a window of opportunity for early identification of diabetes and prediabetes, as women with history of GDM are at increased risk of future glucose intolerance.
引言
世界卫生组织建议在产后六周进行葡萄糖检测，这是检测有妊娠期糖尿病（GDM）病史女性葡萄糖耐量异常的最早时期。本研究旨在确定在柔佛巴鲁政府初级卫生诊所就诊的有GDM病史女性产后六周葡萄糖检测的结果及其相关因素。
方法
本研究为横断面研究，对2016年1月至6月在柔佛巴鲁初级卫生诊所登记且产后六周接受口服葡萄糖耐量试验的有GDM病史女性进行研究。二级数据来自孕产妇健康记录（诊所副本）。使用SPSS 23.0版软件进行数据分析。采用描述性统计和简单逻辑回归分析。
结果
122名有GDM病史的女性完成了产后葡萄糖检测。据报告，这些女性中约12%存在葡萄糖耐量异常。胰岛素使用情况（比值比：5.44；95%置信区间：1.53，19.43；p = 0.009）、糖化血红蛋白异常（比值比：8.70；95%置信区间：2.68，26.27；p < 0.01）、医院随访情况（比值比：3.38；95%置信区间：1.11，10.34；p = 0.033）以及新生儿重症监护病房收治情况（比值比：3.96；95%置信区间：1.16，13.54；p = 0.028）被发现与产后六周葡萄糖耐量异常有显著关联。柔佛巴鲁有GDM病史且产后六周葡萄糖耐量异常的女性比例为12%，这与胰岛素使用情况、糖化血红蛋白异常、医院随访情况以及新生儿重症监护病房收治情况有关。产后筛查为早期识别糖尿病和糖尿病前期提供了一个机会窗口，因为有GDM病史的女性未来发生葡萄糖不耐受的风险增加。
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