中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2014年
3期
404-407
,共4页
妊娠期糖代谢异常%葡糖耐受不良%危险因素%糖尿病家族史%饮食习惯
妊娠期糖代謝異常%葡糖耐受不良%危險因素%糖尿病傢族史%飲食習慣
임신기당대사이상%포당내수불량%위험인소%당뇨병가족사%음식습관
abnormal glucose metabolism during pregnancy%gestational impaired glucose tolerance ( GIGT)%risk factors%diabetic family history%dietary habits
目的：探讨妊娠期糖代谢异常发病的高危因素，为制定有效干预措施提供科学依据。方法采用前瞻性对照研究方法，收集2011年4至9月在珠海市妇幼保健院产科门诊行产前检查诊断的糖代谢异常孕妇（研究组）共108例，其中妊娠期糖尿病（GDM）75例、妊娠糖耐量异常（GIGT）33例；收集同期糖代谢正常孕妇91例（对照组），对两组孕妇的临床资料进行单因素及多因素回归分析，探讨各因素对妊娠期糖代谢异常发病的影响。结果一般情况分析显示，糖代谢异常孕妇年龄、孕前身体质量指数（ BMI）、孕期体重增长、孕次及产次均大于正常孕妇（ t 值分别为-6．567、-4．818、-1．929、-3．231、-3．270，均P＜0．05）；糖代谢异常孕妇高中以下文化程度的比例较对照组高，差异有统计学意义（χ2＝5．642，P＜0．05）。单因素分析发现，孕次、产次、文化程度、年龄≥30岁、孕前BMI≥24kg/m2、糖尿病家族史、不良孕产史、高脂血症、反复发生霉菌性阴道炎（ VCC）、孕期大量甜食、孕期大量水果、孕期锻炼等因素与糖代谢异常的发生相关。多因素Logistic回归分析表明，孕期大量甜食、孕期大量水果、糖尿病家族史、孕前BMI≥24kg/m2、VCC、年龄≥30岁、孕期锻炼7个因素进入主效应模型，其中孕期锻炼为保护性因素，其他为危险因素。结论不合理饮食、糖尿病家族史、孕前超重、年龄≥30岁、反复发生霉菌性阴道炎为影响妊娠期糖代谢异常发生的高危因素，孕期锻炼为保护性因素。对存在高危因素的妇女在产前检查时应加强监护和指导。
目的：探討妊娠期糖代謝異常髮病的高危因素，為製定有效榦預措施提供科學依據。方法採用前瞻性對照研究方法，收集2011年4至9月在珠海市婦幼保健院產科門診行產前檢查診斷的糖代謝異常孕婦（研究組）共108例，其中妊娠期糖尿病（GDM）75例、妊娠糖耐量異常（GIGT）33例；收集同期糖代謝正常孕婦91例（對照組），對兩組孕婦的臨床資料進行單因素及多因素迴歸分析，探討各因素對妊娠期糖代謝異常髮病的影響。結果一般情況分析顯示，糖代謝異常孕婦年齡、孕前身體質量指數（ BMI）、孕期體重增長、孕次及產次均大于正常孕婦（ t 值分彆為-6．567、-4．818、-1．929、-3．231、-3．270，均P＜0．05）；糖代謝異常孕婦高中以下文化程度的比例較對照組高，差異有統計學意義（χ2＝5．642，P＜0．05）。單因素分析髮現，孕次、產次、文化程度、年齡≥30歲、孕前BMI≥24kg/m2、糖尿病傢族史、不良孕產史、高脂血癥、反複髮生黴菌性陰道炎（ VCC）、孕期大量甜食、孕期大量水果、孕期鍛煉等因素與糖代謝異常的髮生相關。多因素Logistic迴歸分析錶明，孕期大量甜食、孕期大量水果、糖尿病傢族史、孕前BMI≥24kg/m2、VCC、年齡≥30歲、孕期鍛煉7箇因素進入主效應模型，其中孕期鍛煉為保護性因素，其他為危險因素。結論不閤理飲食、糖尿病傢族史、孕前超重、年齡≥30歲、反複髮生黴菌性陰道炎為影響妊娠期糖代謝異常髮生的高危因素，孕期鍛煉為保護性因素。對存在高危因素的婦女在產前檢查時應加彊鑑護和指導。
목적：탐토임신기당대사이상발병적고위인소，위제정유효간예조시제공과학의거。방법채용전첨성대조연구방법，수집2011년4지9월재주해시부유보건원산과문진행산전검사진단적당대사이상잉부（연구조）공108례，기중임신기당뇨병（GDM）75례、임신당내량이상（GIGT）33례；수집동기당대사정상잉부91례（대조조），대량조잉부적림상자료진행단인소급다인소회귀분석，탐토각인소대임신기당대사이상발병적영향。결과일반정황분석현시，당대사이상잉부년령、잉전신체질량지수（ BMI）、잉기체중증장、잉차급산차균대우정상잉부（ t 치분별위-6．567、-4．818、-1．929、-3．231、-3．270，균P＜0．05）；당대사이상잉부고중이하문화정도적비례교대조조고，차이유통계학의의（χ2＝5．642，P＜0．05）。단인소분석발현，잉차、산차、문화정도、년령≥30세、잉전BMI≥24kg/m2、당뇨병가족사、불량잉산사、고지혈증、반복발생매균성음도염（ VCC）、잉기대량첨식、잉기대량수과、잉기단련등인소여당대사이상적발생상관。다인소Logistic회귀분석표명，잉기대량첨식、잉기대량수과、당뇨병가족사、잉전BMI≥24kg/m2、VCC、년령≥30세、잉기단련7개인소진입주효응모형，기중잉기단련위보호성인소，기타위위험인소。결론불합리음식、당뇨병가족사、잉전초중、년령≥30세、반복발생매균성음도염위영향임신기당대사이상발생적고위인소，잉기단련위보호성인소。대존재고위인소적부녀재산전검사시응가강감호화지도。
Objective To explore the risk factors of abnormal glucose metabolism during pregnancy , so as to provide evidence for effective intervention .Methods A prospective case-control study was performed among 108 women with abnormal glucose metabolism [ study group , including 75 cases with gestational diabetes mellitus (GDM) and 33 with gestational impaired glucose tolerance (GIGT)] and 91 normal pregnant women ( control group ) recruited from April to September of 2011 in Zhuhai Maternity and Child Health Hospital .Univariate analysis and multivariate logistic regression analysis were conducted to identify risk factors of abnormal glucose metabolism during pregnancy .Results The mean age , body mass index ( BMI ) before pregnancy , maternal weight gains during pregnancy , gravidity and parity were significantly different between study group and control group ( t value was -6.567, -4.818, -1.929, -3.231 and-3.270, respectively, all P<0.05).The proportion of study group with lower education than senior high school was significantly higher than that of control group (χ2 =5.642,P<0.05).Univariate analysis showed that many factors were related with abnormal glucose metabolism, including gravidity, parity, education background, age≥30 years, BMI≥24kg/m2 before pregnancy, diabetes family history, bad pregnancy or reproduction history , hypertriglyceridemia , recurrent vulvovaginal candidiasis ( VVC) history, craving for sweets , large amount of fruits and exercise during pregnancy .Multivariate logistic regression showed that seven factors came into main effect model , including craving for sweets during pregnancy , craving for fruits during pregnancy , diabetes family history , BMI≥24kg/m2 before pregnancy, VCC, age≥30 years and exercise during pregnancy .All were risk factors except exercise.Conclusion Poor eating habits, family history of diabetes , over weight before gestation , maternal age≥30 and recurrent VCC are high risk factors for gestational abnormal glucose metabolism .Exercise during pregnancy is protective factor .More guidance should be provided for the pregnant women with the above high risk factors during antenatal care visits .
