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目的分析初孕妇妊娠糖尿病(GDM)与产后糖尿病(T2DM)发病因素,为筛查、管理GDM与产后T2DM,节省卫生资源,提高妊娠保健工作效用提供依据。方法筛选2012年5月-2014年5月到某院门诊以及分娩孕妇GDM患者185例纳入GDM组,按照年龄(±2年)、孕周(±1周)匹配,选取同期门诊、分娩未罹患GDM正常孕妇185例纳入非GDM组,进行问卷调查、跟踪随访。对罹患GDM孕产妇进行常规治疗干预,筛查产后T2DM。结果 GDM组年龄、受教育水平、家庭月净收入与非GDM组差异无统计学意义(P>0.05);DM家族史、孕前体重指数、孕期增重过多、孕期运动成为GDM发生独立风险因素,OR风险比分别为2.89、2.83、1.87、0.49;T2DM患者18例,T2GM组初次产检、末次产检、产后6~12周FPG水平高于转归对照组,末次产检、产后6~12周OGTT 2h水平高于转归对照组,T2GM组孕期血糖控制达标率低于转归对照组,差异均具有统计学意义(P<0.05)。结论在排除年龄、孕周因素后,受教育水平并不是GDM影响因素;遗传、体质、孕期保健对GDM发生影响较显著;对确诊为GDM患者开展干预非常必要,干预效果直接影响G2TM发生风险。
Objective To analyze the incidence of gestational diabetes mellitus (GDM) and postpartum diabetes mellitus (T2DM) in the first trimester of pregnant women, and provide the basis for screening, managing GDM and postpartum T2DM, saving health resources and improving the health care efficacy of pregnancy. Methods Screening 185 patients with GDM from outpatients and pregnant women during May 2012 to May 2014 were enrolled in the GDM group and were matched for age (± 2 years) and gestational age (± 1 week) 185 pregnant women with normal GDM were enrolled in non-GDM group and were surveyed and followed up. GDM pregnant women suffering from conventional treatment intervention, screening postpartum T2DM. Results There was no significant difference in age, education level, net monthly household income and non-GDM group (P> 0.05). DM family history, body mass index before pregnancy, excessive weight gain during pregnancy and pregnancy were independent risk factors for GDM , OR risk ratio were 2.89,2.83,1.87,0.49; T2DM patients in 18 cases, T2GM group initial check-up, the final production examination, 6 to 12 weeks postpartum FPG levels were higher than the outcome of the control group, the final production examination, postpartum 6 to 12 weeks OGTT 2h level was higher than that of the control group. The rate of glycemic control in T2GM group was lower than that in the control group (P <0.05). Conclusion After excluding the factors of age and gestational age, education level is not the influencing factor of GDM. Genetics, physical fitness and health care during pregnancy have significant effect on GDM. It is very necessary to intervene in diagnosing GDM. The intervention effect has a direct impact on the risk of GDM.