Zhao Dong, Yuan ShaSha, Ma Yan, An Ya Xin, Yang Yu Xian, Yang Jin Kui
Department of Endocrinology, Beijing Tongren Hospital.
Department of Endocrinology, Beijing Luhe Hospital, Capital Medical University.
Medicine (Baltimore). 2020 Apr;99(17):e19663. doi: 10.1097/MD.0000000000019663.
Hyperglycemia in pregnancy (HIP) is related to adverse pregnancy outcomes. However, women with hyperglycemia in the second and third trimester of pregnancy (HISTTP) were not been observed. We aim to reveal associations between HISTTP and prematurity. To confirm which risk factor is better in predicting preterm delivery.This retrospective study included 660 patients, of which 132 have HISTTP and 528 have euglycemia. Univariate analysis was used to extract risk factors and multivariates logistic regression analysis to obtain odds ratio (OR) for prematurity. Mean decrease gini (MDG) in random forest algorithm was used to rank the risk factors.HISTTP women have higher prepregnancy BMI and a higher percentage of family history of hypertension, maternal adiposity, maternal anemia, gestational diabetes mellitus (GDM), prematurity, neonatal asphyxia in 1-minute (P < .05). Univariate analysis of prematurity showed that preterm women had higher rate of HISTTP (P < .01), second births, elderly pregnancy, hypertention, family history of hypertention and multiple perinatal infant (P < .05). Multivariate logistic regression analysis indicates that HISTTP (OR = 2.984, P = .0017), maternal hypertension (OR = 5.208, P = .001) and multiple perinatal infants (OR = 59.815, P < .0001) are independent risk factors for prematurity. After ranked the MDG, the top 3 risk factors were multiple perinatal infants, maternal hypertension, HISTTP. MDG of HISTTP is higher than that of GDM.Women with HISTTP deserve to be concerned, whose prematurity rate are increased. HISTTP is an independent risk factor and a better predictor of prematurity.
妊娠期高血糖(HIP)与不良妊娠结局相关。然而,未观察到妊娠中晚期高血糖的女性(HISTTP)。我们旨在揭示HISTTP与早产之间的关联。以确定哪种风险因素在预测早产方面更佳。这项回顾性研究纳入了660例患者,其中132例有HISTTP,528例血糖正常。采用单因素分析提取风险因素,并通过多因素逻辑回归分析获得早产的优势比(OR)。使用随机森林算法中的平均基尼系数减少量(MDG)对风险因素进行排名。HISTTP女性孕前BMI较高,高血压家族史、母体肥胖、母体贫血、妊娠期糖尿病(GDM)、早产、新生儿1分钟窒息的比例更高(P<0.05)。早产的单因素分析显示,早产女性的HISTTP发生率更高(P<0.01),二胎、高龄妊娠、高血压、高血压家族史和多胎围产儿的发生率更高(P<0.05)。多因素逻辑回归分析表明,HISTTP(OR=2.984,P=0.0017)、母体高血压(OR=5.208,P=0.001)和多胎围产儿(OR=59.815,P<0.0001)是早产的独立风险因素。在对MDG进行排名后,前3位风险因素是多胎围产儿、母体高血压、HISTTP。HISTTP的MDG高于GDM。患有HISTTP的女性值得关注,她们的早产率增加。HISTTP是早产的独立风险因素且是更好的预测指标。