简介:AbstractObjective:This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy.Methods:This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model.Results:In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257-1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277-2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883-3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051-1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162-1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035-1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy.Conclusion:For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.
简介:摘要目的探讨GDM孕妇病治疗及人数增加的原因。方法选择在我院进行孕期糖筛查和糖耐量检查确诊为GDM孕妇的患者60例作为研究对象,其中年龄分布为28.7±6.7岁。GDM孕妇临床诊断标准为乐杰主编的《妇产科学》关于妊娠糖尿病的诊断标准。所有研究对象均经临床孕期糖筛查及糖耐量检查确诊。收集患者发生糖尿病原因及查阅文献整理可能存在的原因。结果研究显示临床GDM孕妇采用有针对性的治疗和干预后,治疗前后临床各项指标(SHBG、FINS、FBG和IR)均没有统计学意义(P>0.05),说明经对症治疗临床疗效一般。引起临床GDM孕妇的原因包括遗传因素、激素异常、肥胖、饮食结构、年龄、环境和心理因素等。结论GDM孕妇临床发病由多种原因引起,应针对不同原因制定对象的预防策略,才能达到加好的治疗效果。
简介:摘要:目的 探析宫颈双球囊及普贝生在妊娠期糖尿病孕妇引产活动中的临床效果。方法 回顾性分析本院2016年3月~2019年7月收治的88例妊娠期糖尿病孕妇的临床资料,依照不同引产方式分组,接受普贝生引产的43例,接受宫颈双球囊引产的45例,比较两组产中血糖情况、引产前后宫颈评分、产程时间、并发症发生情况及引产成功率。结果 球囊组血糖代谢情况对比无明显差异(P>0.05),普贝生组宫缩过强发生率显著高于球囊引产组(P<0.05),其余并发症情况对比,差异没有统计学意义(P>0.05)。两组引产前后宫颈评分对比无明显差异(P>0.05),引产成功率对比为球囊组引产成功率高于普贝生组,差异无统计学意义(P>0.05)。结论 妊娠期糖尿病孕妇引产中宫颈双球囊与普贝生均具有良好的引产效果,但宫颈双球囊安全性较普贝生更高,引产成功率更高。
简介:摘要目的探讨综合护理干预方案应用于妊娠期糖尿病(GDM)孕妇及其对围生儿结局的影响。方法研究对象选取我院分娩并住院的孕产妇126例,所有患者的临床资料均符合纳入和排除标准。按照孕产妇的护理方案,将其分为研究组(综合护理方案组,n=63)和对照组(常规护理方案组,n=63)。对两组孕产妇的血糖控制情况、妊娠结局分析及GDM产妇SAS和SDS评分进行比较。结果(1)研究组患者治疗后的靴筒控制情况明显优于对照组,差异具有统计学意义(P<0.05)。(2)研究组产妇在会阴侧切率、产妇并发症发生率、新生儿窒息率的比较中,差异比较具有统计学意义(P<0.05)。(3)两组产妇护理前SAS评分及SDS评分比较,差异不具有统计学意义(P≥0.05),两组产妇护理后SAS评分及SDS评分比较,差异具有统计学意义(P<0.05)。结论综合护理方案可以有效地控制患者血糖,是围生儿的结局得到良好的改善,同时提高患者满意度,改进我院护理人员的工作质量,为GDM孕产妇及围生儿的结局提供有力的保障,本法值得在基层医院进行临床推广。
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简介:摘要目的探讨白细胞介素(IL)-16基因多态性与妊娠期糖尿病(GDM)易感性的关联性,并分析其对妊娠结局的影响。方法连续性选取2018年1月至2020年1月海南省妇女儿童医学中心收治的125例GDM患者作为GDM组,另依据1 ∶1配对原则选取同期、同年龄段、同孕周的125名健康孕妇作为对照组。比较两组基线资料、IL-16基因多态性、血清IL-16水平,并比较GDM不同IL-16基因型患者空腹血糖(FPG)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)、口服葡萄糖耐量试验(OGTT)结果,采用logistic回归方程分析GDM的相关影响因素,比较GDM不同基因型患者妊娠结局。结果GDM组有糖尿病家族史占比(15.20%)高于对照组(4.00%),血清IL-16水平高于对照组(P均<0.05);GDM组IL-16基因rs11556218位点GG基因型占比(12.00%)、等位基因G占比(33.60%)均高于对照组(1.60%、21.20%),P均<0.05;IL-16基因rs11556218位点GG基因型GDM患者FPG、HOMA-IR、OGTT 0、1、2 h血糖值及血清IL-16水平高于TT、TG基因型患者(P均<0.05);有糖尿病家族史、血清IL-16水平升高、IL-16基因rs11556218位点基因型为GG均与GDM的发生显著相关(P均<0.05);rs11556218位点GG基因型会增加GDM患者不良妊娠结局发生率。结论IL-16基因rs11556218位点基因多态性与GDM易感性显著相关,其GG基因型可增加不良妊娠结局发生率。