妊娠期糖尿病患者血糖水平 妊娠结局及危险因素分析

目的分析妊娠期糖尿病(GDM)患者血糖水平、妊娠结局及其危险因素。方法选取2018年1月至2019年6月安徽医科大学附属巢湖医院产科收治的105例GDM患者,依据产前空腹血糖(FBG)是否达标,分为良好组(n=55)与非良好组(n=50),分析其相关指标及危险因素。结果两组患者产前、产后FBG、餐后2小时血糖(2 h PBG)水平的差异有统计学意义(P<0.05),两组患者产前与产后FBG、2 h PBG水平的差值进行比较,差异无统计学意义(P>0.05)。良好组患者产程中血糖水平低于非良好组,差异有统计学意义(P<0.05)。良好组患者代谢因素不良妊娠结局(妊娠期高血压、羊水过少、胎膜早破、早产、巨大儿)发生率低于非良好组,差异有统计学意义(P<0.05);多因素logisitic回归分析结果显示,年龄35～44岁、孕前身体质量指数(BMI)24～36.20 kg/m²是血糖控制的危险因素(P<0.05),高中及以上文化程度是其保护因素(P<0.05);受试者工作特征曲线结果显示,孕前BMI预测血糖控制风险的最佳截断点为21....

Analysis of level of blood glucose and pregnancy outcomes inpatients with gestational diabetes mellitus

Objective To explore the levels of blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus (GDM), and to analyze their related risk factors. Methods From January 2018 to June 2019, a total of 105 patients with GDM were selected in the Department of Obstetrics, the Chaohu Hospital of Anhui Medical University. All of the subjects were divided into good group(55 cases) and non-good group (50 cases) according to whether the fasting blood glucose level was up to standard during prenatal period, and their relevant indicators and risk factors were explored. Results The levels of FBG and 2 h PBG before and after delivery were significantly different between the two groups (P<0.05), but the D-value showed no significant difference between the two groups(P>0.05). The blood glucose level of patients in good group was lower than that in non-good group(P<0.05).Likewise, pregnancy-induced hypertension, oligohydramnios, premature rupture of membranes, premature delivery and macrosomia, the incidence of adverse pregnancy outcome sassociated with metabolic factors were lower in good group than those in non-good group (P<0.05). Multiple logistic regression analysis indicated that the age equal or greater than 35 years old was a risk factor for controlling blood glucose level, and the same with their pre-pregnancy BMI equal or greater than 24 kg/m² (P<0.05). On the contrary, senior high school education or above was a protective factor(P<0.05). Receiver operator characteristic curve analysis showed the optimal truncation value of pre-pregnancy BMI was 21.935 kg/m²for predicting the risk of controlling blood glucose level, and the area under the curve was 0.725, the sensitivity was 80.00%, and the specificity was 60.00%. Conclusions The abnormal glucose metabolism in patients with GDM is consistent during pregnancy with postpartum. The level of blood glucose controlled effectively could reduce the adverse pregnancy outcomes associated with metabolic factors. The patients with GDM accompanied by older pregnancy or pre-pregnancy overweight or poor education are the main population for clinical intervention.