孕前体质量指数及孕期增重与妊娠期糖尿病的相关性分析_周金嫦.pdf

462022 Vol.9 No.11Electronic Journal of Practical Gynecological Endocrinology论 著孕前体质量指数及孕期增重与妊娠期糖尿病的相关性分析 周金嫦（广西壮族自治区民族医院 产科，广西 南宁 530000）【摘要】目的 探讨孕前体质量指数及孕期增重与妊娠期糖尿病的相关性。方法 选择本院接收的产检孕妇113例为研究对象，按照是否并发糖尿病分为妊娠期糖尿病组30例和非妊娠期糖尿病组83例，分析两组患者的一般资料、孕次、产次、孕前体质量指数、孕期增重、糖尿病家族史，单因素分析妊娠期糖尿病的危险因素，对单因素显著的危险因素采取Logistic多因素回归分析。结果 妊娠期糖尿病组患者的孕前超重率为40.00%、肥胖率为16.67%，孕期体质量过高增长率为56.67%，合并糖尿病家族史率60.00%，均显著高于非妊娠期糖尿病组的14.46%、13.25%、24.10%、20.48%，差异有统计学意义（P0.05）；两组的年龄、孕次、产次比较，差异无统计学意义（P0.05）。多因素Logistic回归分析显示，孕前超重、孕前肥胖、孕期体质量过高增长、合并糖尿病家族史为妊娠期糖尿病的危险因素（P0.05）。结论 妊娠期糖尿病与年龄、孕次、产次无明显关系，合并糖尿病家族史、孕前超重及肥胖、孕期体质量增长过高则为引发妊娠期糖尿病的危险因素，需重视对该类孕妇的监护及体质量控制，保证母婴健康。【关键词】妊娠期糖尿病；孕前体质量指数；孕期增重；糖尿病家族史；危险因素Correlation analysis of pre-pregnancy body mass index,weight gain during pregnancy and gestational diabetes mellitusZhou Jinchang(Department of Obstetrics,Guangxi Zhuang Autonomous Region Ethnic Hospital,Nanning 530000,China)【Abstract】Objective To investigate the correlation between pre-pregnancy body mass index,weight gain during pregnancy and gestational diabetes mellitus.Methods A total of 113 pregnant women who received obstetric examinations in our hospital were selected as the research objects.They were divided into the gestational diabetes group(30 cases)and the non-gestational diabetes group(83 cases)according to whether they were complicated with diabetes.The general data,parity,prepregnancy body mass index,weight gain during pregnancy and family history of diabetes in the two groups were analyzed.The risk factors of gestational diabetes were analyzed by univariate analysis.Logistic multivariate regression analysis was used to analyze the significant risk factors of gestational diabetes.Results The pre-pregnancy overweight rate was 40.00%,the pre-pregnancy obesity rate was 16.67%,the increase rate of excess weight during pregnancy was 56.67%,and the family history of diabetes was 60.00%in the gestational diabetes group,which were significantly higher than 14.46%,13.25%,24.10%,20.48%in the non-gestational diabetes group,the differences were statistically significant(P0.05);there were no significant differences in age,parity and parity between the two groups(P0.05).Multivariate Logistic regression analysis showed that,pre-pregnancy overweight,pre-pregnancy obesity,excessive weight gain during pregnancy and family history of diabetes were risk factors for gestational diabetes mellitus（P0.05）.Conclusion There is no significant relationship between gestational diabetes mellitus and age,parity and parity.Family history of diabetes mellitus,overweight and obesity before pregnancy,and excessive body mass gain during pregnancy are risk factors for gestational diabetes mellitus.It is necessary to pay attention to the monitoring and body mass control of such pregnant women to ensure maternal and infant health.【Key words】Gestational diabetes mellitus;Pre-Pregnancy body mass index;Weight gain during pregnancy;Family history of diabetes;Risk factorsDOI：10.3969/j.issn.2095-8803.2022.11.013通信作者：周金嫦，E-mail：472022 年第 9 卷第 11 期实用妇科内分泌电子杂志论 著妊娠期糖尿病为妊娠期常见的并发症，是指因妊娠后母体代谢异常而首次发生的糖尿病，虽然孕期无明显症状，但会导致多种妊娠不良结局，如剖宫产、产后出血、早产、流产、巨大儿等，严重危害母婴健康及生命安全，因此，临床需重视妊娠期糖尿病的预防及早期控制1。由于引发妊娠并发症的原因较多，为实现对孕妇的高效管理，应筛选高风险人群加强孕期监护，因肥胖是糖尿病的危险因素，故需重视孕前体质量指数的筛查，明确其与妊娠期糖尿病的相关性，此外，还需关注孕期增重情况，因体质量增加过多提示妊娠期营养过剩、营养不均衡，故应明确其与妊娠期糖尿病及不良妊娠结局的相关性2。为此，本研究对孕前体质量指数及孕期增重与妊娠期糖尿病的相关性进行了探讨，现报道如下。1 资料与方法1.1 临床资料选择2019年1月至2021年12月本院接收的产检孕妇113例为研究对象，按照是否并发糖尿病分为妊娠期糖尿病组30例和非妊娠期糖尿病组83例。纳入标准：妊娠期糖尿组经糖耐量检查确诊，满足美国糖尿病协会（ADA）推荐的妊娠期糖尿病标准3；非妊娠期糖尿病组经临床诊治无妊娠期糖尿病。排除标准：孕前确诊糖尿病者；孕前合并严重内外科疾病者；存在沟通或交流障碍者；未进行规范产检者。孕妇年龄2040岁，平均（29.752.42）岁；孕前体质量指数17.230.2 kg/m2，平均（23.141.79）30.2 kg/m2；孕次14次，平均（1.880.38）次；产次13次，平均（1.260.12）次。本研究经医院医学伦理委员会批准，患者均知晓本研究，并自愿签署知情同意书。1.2 方法比较两组患者的年龄（30岁，30岁）、孕次（1次，2次）、产次（1次，2次）、孕前体质量指数、孕期增重、糖尿病家族史（是、否）。孕前体质量指数：轻体质量：BMI18.5 kg/m2，健康体质量：18.523.9 kg/m2，超重：24.027.9 kg/m2，肥胖：28.0 kg/m2；孕期增重标准：低体质量12.518.0 kg，正常体质量11.516.0 kg，超重7.011.5 kg，肥胖5.09.0 kg，若低于标准为低度增长，符合标准为正常增长，超过标准为过高增长。经单因素与多因素Logistic回归分析妊娠期糖尿病的危险因素。1.3 统计学方法采用SPSS 22.0统计学软件对数据进行统计分析。计数资料以n（%）表示，采用2检验；多因素分析应用Logistic回归模型。P0.05表示差异具有统计学意义。2 结果2.1 妊娠期糖尿病的单因素分析经单因素分析，妊娠期糖尿病组患者的年龄、孕次、产次与非妊娠期糖尿病组比较，差异无统计学意义（P0.05）；妊娠期糖尿病组患者的孕前超重率40.00%、肥胖率16.67%、孕期体质量过高增长率56.67%、合并糖尿病家族史率60.00%均显著高于非妊娠期糖尿病组的14.46%、13.25%、24.10%、20.48%，差异有统计学意义（P0.05）。见表1。表1 单因素分析n（%）项目例数妊娠期糖尿病组（n=30）非妊娠期糖尿病组（n=83）2P年龄30岁6514（46.67）51（61.45）1.9700.16130岁4816（53.33）32（38.55）孕次1次7217（56.67）55（66.27）0.8780.3492次4113（43.33）28（33.73）产次1次8821（70.00）67（80.72）1.4710.2252次259（30.00）16（19.28）孕前体质量指数轻体质量215（16.67）16（19.28）10.3540.016健康体质量528（16.67）44（53.01）超重2412（40.00）12（14.46）肥胖165（16.67）11（13.25）孕期增重低度增长153（10.00）12（14.46）10.6950.005正常增长6110（33.33）51（61.45）过高增长3717（56.67）20（24.10）糖尿病家族史是3518（60.00）17（20.48）16.0960.000否7812（40.00）66（79.52）482022 Vol.9 No.11Electronic Journal of Practical Gynecological Endocrinology论 著2.2 妊娠期糖尿病的Logistic多因素回归分析以单因素中存在差异的因素为变量，多因素Logistic回归分析：孕前超重、肥胖，孕期体质量过高增长，合并糖尿病家族史为妊娠期糖尿病的危险因素（P0.05）。见表2。表2 妊娠期糖尿病的Logistic多因素回归分析变量回归系数标准误差Wald-2POR95%CI超重0.8150.4147.8480.053.1561.758，