上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (6): 637-.doi: 10.3969/j.issn.1674-8115.2018.06.009

• 论著·临床研究 • 上一篇    下一篇

经产妇发生妊娠期糖尿病的危险因素研究

王尹瑜 1，刘晔 1，刘含 1，董则含 1，黄荷凤 1, 2   

  1. 1.上海交通大学医学院附属国际和平妇幼保健院胚胎源性疾病研究所，上海 200030；2. 浙江大学医学院附属妇产科医院生殖遗传教育部重点实验室，杭州 310058
  • 出版日期:2018-06-28 发布日期:2018-07-03
  • 通讯作者: 黄荷凤，电子信箱：huanghefg@hotmail.com。
  • 作者简介:王尹瑜（1991—），男，硕士生；电子信箱：wangyinyu2009@foxmail.com。
  • 基金资助:
    国家自然科学基金委中加合作项目（81661128010）

Risk factors for gestational diabetes mellitus among multiparae

WANG Yin-yu1, LIU Ye1, LIU Han1, DONG Ze-han1, HUANG He-feng1, 2   

  1. 1. Institute of Embryo-Fetal Original Adult Disease, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. The Key Laboratory of Reproductive Genetics (Ministry of Education), Women’s Hospital, Zhejiang University School of Medicine, Hangzhou310058, China
  • Online:2018-06-28 Published:2018-07-03
  • Supported by:
    National Natural Science Foundation of China, Sino-Canadian Joint Program, 81661128010

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摘要： 目的·探究经产妇发生妊娠期糖尿病（gestational diabetes mellitus，GDM）的危险因素。方法·选取2012年1月—2017年1月在国际和平妇幼保健院有连续2次分娩记录的经产妇。按照前次妊娠孕前年龄进行1:4配比，病例组116例，对照组464例。通过病史调取这些孕产妇的临床资料和口服糖耐量试验（oral glucose tolerance test，OGTT）、血脂等生化指标。通过多因素回归分析计算校正比值比（odds ratio，OR）和95% CI,找出经产妇发生GDM的危险因素。结果·相比对照组，病例组孕产妇2次妊娠孕前体质量指数（BMI）增加（校正OR1.35，95% CI为1.07～1.69），前次妊娠OGTT 1 h血糖（校正OR1.99，95% CI为1.55～2.55）和2 h血糖（校正OR2.02，95% CI为1.51～2.70）越高，以及本次妊娠孕早期空腹血糖（校正OR1.96，95% CI为1.16～3.32）、总胆固醇（校正OR1.37，95% CI为1.06～1.77）和三酰甘油（校正OR1.53，95% CI为1.10～2.14）越高，发生GDM的风险越大。结论· 2次妊娠间BMI增加，以及血糖和血脂持续性增长是引起经产妇GDM发生的危险因素。

关键词: 经产妇, 妊娠期糖尿病, 危险因素, 生化指标, 病例对照研究

Abstract:

Objective · To investigate the risk factors for gestational diabetes mellitus (GDM) among multiparae. Methods · Women who had two consecutive pregnancies records in the International Peace Maternity and Child Health Hospital January 2012 to January 2017 were included into this study. The case group (116 cases) and control group (464 cases) were matched at the ratio of 1:4 according to the pre-pregnancy age in index pregnancy. Clinical characteristics, biochemical parameters including oral glucose tolerance test (OGTT) and lipid profiles were took into considerationvirtue of their medical records. Multivariate Logistic regression analysis was used to compute the adjusted odds ratio (aOR) and 95%CI so as to identify the risk factors. Results · Compared with the control group, the case group was associated with greater body mass index (BMI) change between pregnancies(aOR1.35, 95% CI1.07-1.69), greater postprandial 1 h glucose load (aOR1.99, 95% CI1.55-2.55) and 2 h glucose load (aOR2.02, 95% CI1.512.70)at OGTT in index pregnancy, and greater first-trimester fasting plasma glucose (aOR1.96, 95% CI1.16-3.32), total cholesterol (aOR1.37,95% CI1.06-1.77) and triacylglycerol (aOR1.53, 95% CI1.10-2.14) in subsequent pregnancy. Conclusion · The elevated BMI change between pregnancies, the abnormal glucose and lipid profiles persisting index to subsequent pregnancy lead to the occurrence of GDM.

Key words: multipara, gestational diabetes mellitus, risk factor, biochemical parameter, case-control study

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