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围产期结局在糖尿病和肥胖孕妇人群中的表现——波兰全国性调查结果。

Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women-The Results of the Polish National Survey.

机构信息

International Prevention Research Institute-Collaborating Centre, Calisia University, 62-800 Kalisz, Poland.

Club 35, Polish Society of Gynecologists and Obstetricians, 02-677 Warsaw, Poland.

出版信息

Int J Environ Res Public Health. 2021 Jan 11;18(2):560. doi: 10.3390/ijerph18020560.

Abstract

Obesity and diabetes increase the risk of complications during gestation and at delivery. The aim of this study was to compare the perinatal outcomes in the populations of diabetic and obese Polish women, based on the results of a national survey performed in years 2012 and 2017, as well as to determine the risk factors of the gestational diabetes mellitus (GDM). Questionnaires from 6276 women were collected. Obese women constituted 5.5% and 7.5% of study population in years 2012 and 2017, respectively. Among women whose pregnancies were complicated by diabetes mellitus, GDM constituted the most common type of glucose intolerance during both time periods (2012: 89% vs. 2017: 85.6%). In the group of obese women an insignificant increase in the rate of induced deliveries was noted (2012: 9.9% vs. 2017: 11.7%), whereas the fetal birth-weight decreased significantly (2012: 3565 g vs. 2017: 3405 g, < 0.05). In the group of diabetic pregnant women the percentage of cesarean sections, labour inductions and fetal birth defects was characterized by an insignificant upward trend. Risk of GDM was significantly increased in women aged over 35 years-(2012: OR 1.9 (95% CI: 1.1-2.9) and 2017: OR = 2.1 (95% CI: 1.5-2.9), < 0.05-, as well as in overweight women-2012: OR 1.8 (95% CI: 1.2-2.7) and 2017: OR 2.6 (95% CI: 1.9-3.4), < 0.05-during both analysed time periods. Based on the study results, it is necessary to develop population-based programmes to prevent obesity and to introduce and enforce the rules of appropriate screening for glucose tolerance disorders during pregnancy.

摘要

肥胖和糖尿病会增加妊娠和分娩期间并发症的风险。本研究旨在比较波兰糖尿病和肥胖女性人群的围产期结局,依据 2012 年和 2017 年进行的全国性调查结果,并确定妊娠糖尿病(GDM)的危险因素。共收集了 6276 名女性的问卷。2012 年和 2017 年,肥胖女性分别占研究人群的 5.5%和 7.5%。在患有糖尿病的孕妇中,GDM 是两个时期最常见的葡萄糖耐量异常类型(2012 年:89%比 2017 年:85.6%)。在肥胖女性中,引产率略有上升(2012 年:9.9%比 2017 年:11.7%),而胎儿出生体重显著下降(2012 年:3565g 比 2017 年:3405g,<0.05)。在患有糖尿病的孕妇中,剖宫产、引产和胎儿出生缺陷的比例呈上升趋势,但无统计学意义。2012 年和 2017 年,年龄超过 35 岁的女性(OR 1.9(95%CI:1.1-2.9)和 OR = 2.1(95%CI:1.5-2.9),<0.05)以及超重女性(OR 1.8(95%CI:1.2-2.7)和 OR 2.6(95%CI:1.9-3.4),<0.05)患 GDM 的风险显著增加。基于研究结果,有必要制定以人群为基础的预防肥胖计划,并引入和执行怀孕期间适当筛查葡萄糖耐量异常的规则。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22e3/7827210/1a3c88d58c89/ijerph-18-00560-g001.jpg

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