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妊娠期糖尿病相关危险因素分析:一项回顾性病例对照研究

Analysis of Risk Factors Associated with Gestational Diabetes Mellitus: A Retrospective Case-Control Study.

作者信息

Zhong Jing, Zhang Hua, Wu Jie, Zhang Bosen, Lan Liubing

机构信息

Department of Obstetrics, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.

Department of Prenatal Diagnostic Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.

出版信息

Int J Gen Med. 2024 Sep 18;17:4229-4238. doi: 10.2147/IJGM.S473972. eCollection 2024.

Abstract

OBJECTIVE

Gestational diabetes mellitus (GDM) is a complication of abnormal glucose tolerance during pregnancy, with incidence is on the rise. There are inconsistent results on the risks of GDM and it has not been reported in our region. The purpose of this study is to explore the risk factors of GDM.

METHODS

A total of 383 pregnant women were analyzed, including 67 (17.5%) pregnant women with GDM and 316 (82.5%) with normal glucose tolerance (NGT). The relationship of personal history, family history and reproductive history of pregnant women, the levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), inflammatory markers in blood cell analysis at the first prenatal examination, and fetal ultrasound indices and the risk of GDM were analyzed.

RESULTS

The fetal biparietal diameter, head circumference, and femur length were negatively correlated with HCG level, but not inflammatory markers. The proportion of pregnant women aged ≥30 years old, body mass index (BMI) in early pregnancy≥24.0 kg/m, history of polycystic ovary syndrome (PCOS), cesarean section, adverse pregnancy, and oral contraceptive use, and pregnant women who conceived through assisted reproduction in GDM group were higher than those in NGT group. Logistic regression analysis showed that age of pregnant woman ≥30 years old (≥30 vs <30 years old, odds ratio (OR): 2.142, 95% confidence interval (CI): 1.183-3.878, =0.012), BMI≥24.0 kg/m (≥24.0 kg/m vs 18.5-23.9 kg/m, OR: 1.887, 95% CI: 1.041-3.420, =0.036), history of adverse pregnancy (yes vs no, OR: 1.969, 95% CI: 1.022-3.794, =0.043), and history of oral contraceptive use (yes vs no, OR: 2.868, 95% CI: 1.046-7.863, =0.041) were associated with GDM.

CONCLUSION

Age of pregnant woman ≥30 years old, BMI≥24.0 kg/m, history of adverse pregnancy and oral contraceptive use were independent risk factors for GDM.

摘要

目的

妊娠期糖尿病(GDM)是孕期糖耐量异常的一种并发症,其发病率呈上升趋势。关于GDM的风险存在不一致的结果,且在我们地区尚未见报道。本研究的目的是探讨GDM的危险因素。

方法

共分析了383名孕妇,其中67名(17.5%)患有GDM的孕妇和316名(82.5%)糖耐量正常(NGT)的孕妇。分析了孕妇的个人史、家族史和生育史、首次产前检查时血细胞分析中的甲胎蛋白(AFP)、人绒毛膜促性腺激素(HCG)、炎症标志物水平,以及胎儿超声指标与GDM风险的关系。

结果

胎儿双顶径、头围和股骨长度与HCG水平呈负相关,但与炎症标志物无关。GDM组中年龄≥30岁、孕早期体重指数(BMI)≥24.0 kg/m、多囊卵巢综合征(PCOS)史、剖宫产史、不良孕史和口服避孕药史以及通过辅助生殖受孕的孕妇比例高于NGT组。Logistic回归分析显示,孕妇年龄≥30岁(≥30岁与<30岁相比,比值比(OR):2.142,95%置信区间(CI):1.183 - 3.878,P = 0.012)、BMI≥24.0 kg/m(≥24.0 kg/m与18.5 - 23.9 kg/m相比,OR:1.887,95% CI:1.041 - 3.420,P = 0.036)、不良孕史(是与否相比,OR:1.969,95% CI:1.022 - 3.794,P = 0.043)和口服避孕药史(是与否相比,OR:2.868,95% CI:1.046 - 7.863,P = 0.041)与GDM相关。

结论

孕妇年龄≥30岁、BMI≥24.0 kg/m、不良孕史和口服避孕药史是GDM的独立危险因素。

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