2015 年至 2021 年西安孕妇葡萄糖值异常和妊娠糖尿病的患病率。

Prevalence of abnormal glucose values and gestational diabetes mellitus among pregnant women in Xi'an from 2015 to 2021.

机构信息

Department of Clinical Laboratory, Northwest Women's and Children's Hospital, Xi'an, 710061, China.

Department of Clinical Laboratory, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.

出版信息

BMC Pregnancy Childbirth. 2023 Jun 24;23(1):471. doi: 10.1186/s12884-023-05798-w.

DOI:10.1186/s12884-023-05798-w

PMID:37355571

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10290305/

Abstract

BACKGROUND

Pregnant women with gestational diabetes mellitus (GDM) often have an increased risk of adverse pregnancy outcomes. The purpose of this study was to explore the prevalence and characteristics of GDM in Xi'an from 2015 to 2021 since the implementation of China's "Two-Child policy" and to provide a clinical basis for the management of GDM.

METHODS

We analyzed the oral glucose tolerance test (OGTT) results of 152,836 pregnant women who underwent routine prenatal examination at the Northwest Women and Children's Hospital from 2015 to 2021. Additionally, we analyzed the GDM prevalence and characteristics.

RESULTS

The prevalence of GDM in the Xi'an urban area was 24.66% and exhibited an increasing trend annually (χ2 for trend = 43.922, p < 0.001) and with age (χ2 for trend = 2527.000, p < 0.001). Consistent with this, the proportion of pregnant women aged 18-25 and 26-30 years decreased significantly with the annual growth (χ2 for trend = 183.279, p < 0.001 and χ2 for trend = 33.192, p < 0.001, respectively). The proportion of pregnant women aged 31-35 and 36-42 years increased gradually annually (χ2 for trend = 134.436, p < 0.001and χ2 for trend = 44.403, p < 0.001, respectively). Of the pregnant women diagnosed with GDM, 71.15% (65.05-74.95%) had abnormal fasting plasma glucose (FPG) values. The highest percentage of patients had a single abnormal OGTT value (68.31%; 65.77-70.61%), followed by two (20.52%; 18.79-22.55%) and three (11.17%; 10.11-11.85%) abnormal values (FPG and 1-h and 2-h plasma glucose (PG).

CONCLUSION

The prevalence of GDM among pregnant women in Xi'an region was high, and it had a increasing trend over the period from 2015 to 2021. Notably, the proportion of elder pregnant women, aged 31-42 years, presented a significant rise after the implementation of the universal two-child policy. On the basis of the high incidence of GDM among elder pregnant women and the high rate of abnormal OGTT values (numbe ≥ 2) in pregnant women diagnosed with GDM, the management of GDM should be intensified, and relevant departments should pay more attention to pregnant women of advanced age.

摘要

背景

患有妊娠期糖尿病（GDM）的孕妇通常存在不良妊娠结局的风险增加。本研究旨在探讨 2015 年至 2021 年中国“二孩政策”实施以来西安地区 GDM 的患病率和特征，为 GDM 的管理提供临床依据。

方法

我们分析了 2015 年至 2021 年在西北妇女儿童医院进行常规产前检查的 152836 名孕妇的口服葡萄糖耐量试验（OGTT）结果。此外，我们还分析了 GDM 的患病率和特征。

结果

西安城区 GDM 的患病率为 24.66%，呈逐年上升趋势（趋势 χ2=43.922，p<0.001），且与年龄有关（趋势 χ2=2527.000，p<0.001）。随着年龄的增长，18-25 岁和 26-30 岁孕妇的比例显著下降（趋势 χ2=183.279，p<0.001 和 χ2=33.192，p<0.001）。31-35 岁和 36-42 岁孕妇的比例则逐渐增加（趋势 χ2=134.436，p<0.001 和 χ2=44.403，p<0.001）。诊断为 GDM 的孕妇中，71.15%（65.05%-74.95%）的空腹血糖（FPG）值异常。OGTT 单项异常的患者比例最高（68.31%；65.77%-70.61%），其次是两项（20.52%；18.79%-22.55%）和三项（11.17%；10.11%-11.85%）异常（FPG 和 1h 和 2h 血糖）。

结论

西安地区孕妇妊娠期糖尿病的患病率较高，且自 2015 年至 2021 年呈上升趋势。特别是在普遍实施二孩政策后，31-42 岁的高龄孕妇比例显著上升。基于高龄孕妇妊娠期糖尿病发病率高，以及诊断为妊娠期糖尿病的孕妇中异常 OGTT 值（numbe≥2）比例高的特点，应加强妊娠期糖尿病的管理，相关部门应更加关注高龄孕妇。