Risk Factors Of Gestational Diabetes Mellitus And Nursing Intervention Study On The Effect Of Maternal And Neonatal Outcomes

ObjectivesTo analyze the risk factors of gestational diabetes mellitus (Gestational Diabetes Mellitus, GDM)and their impact on pregnancy outcomes, provide some basis for GDM early screening and reduce the GDM rate of misdiagnosis,In order to develop targeted GDM early prevention and to provide reference data for assessment of maternal-fetal risk; Explore the impact of diet control and exercise and other care interventions on maternal and child outcomes in GDM, to provide some effective nursing interventions methods for the GDM, and provide some basis for reduce maternal complications.Subjects and methods1.263GDM women were investigated from January2007～July2010who delivered in the First Affiliated Hospital of Guangxi Medical University, as the case group, and the same period,274without GDM women who delivered in our hospital were randomly selected as control group. Recording two groups of maternal age, education level, ethnicity, pre-pregnancy body mass index, prenatal body mass index, and weight gain during pregnancy, gravidity, parity, abortion, family history of diabetes, family history of malignant neoplasm, to analyze the risk factors of GDM. Review the analysis of two groups of maternal and their neonates data, Compared the two groups of maternal and their neonates outcomes, to analyze the impact of GDM on pregnancy outcomes of mother and child.2.58cases of pregnant women who diagnosed with GDM in the First Affiliated Hospital of Guangxi Medical University obstetric were Selected from August2010-August2011, for the experimental group, and randomly selected68cases of the pregnant women with GDM from January2007～July2010who delivered in our hospital obstetric as the control group, Giving nursing interventions such as diet and exercise care in the experimental group of pregnant women, compared between the two groups of maternal and their neonates outcomes, analysis of diet control and exercise care interventions on the mother-child pregnancy outcome.3. We analyzed the data with SPSS13.0software package and tested the statistical significance with descriptive analysis, t-test, chi-square test, single factor analysis, multiple Logistic regressions.Results1. The results of single factor analysis showed, the GDM group and control group in pregnant age, educational level, the times of pregnancy,parity, abortion, family history of diabetes, pre-pregnancy BMI, prenatal BMI and weight gain during pregnancy, the difference was statistically significant (P<0.05). Logistic regression analysis of risk factors of GDM as follows:pregnant age, the times of pregnancy, abortion, family history of diabetes, weight gain during pregnancy are the risk factors of GDM, among them, education is a protective factor for GDM. 2. The polyhydrarnnios, postpartum hemorrhage, pregnancy induced hypertension, great children, neonatal asphyxia incidence rate of GDM group were higher than that in the control group, and the difference was statistically significant (P<0.05); the preterm birth, cesarean section, great children, neonatal hypoglycemia, neonatal hyperbilirubinemia, neonatal transfer neonatology treatment and perinatal death incidence rate of GDM group were higher than that in the control group, and the difference was statistically significant(p<0.01). the amniotic fluid, amniotic rupture of membranes, fetal distress, birth defects incidence rate of GDM group were higher than that in the control group, but the difference was not statistically significant (p>0.05).3. The preterm birth, cesarean section, polyhydrarnnios, postpartum hemorrhage, great children, neonatal asphyxia, neonatal transfer neonatology treatment and perinatal death incidence rate of control group were higher than that in the experimental group, and the difference was statistically significant (P <0.05); the pregnancy induced hypertension, fetal distress, and neonatal hyperbilirubinemia incidence rate of control group were higher than that in the experimental group, and the difference was statistically significant (p<0.01); the neonatal hypoglycemia, birth defects incidence rate of control group were higher than that in the experimental group, but the difference was not statistically significant (p>0.05).Conclusion1. Pregnant women of pregnant age, the times of pregnancy, abortion, family history of diabetes, weight gain during pregnancy may be risk factors of pregnant women for GDM; education may be a protective factor of GDM.2. Premature birth, cesarean section, postpartum hemorrhage, fetal distress and pregnancy induced hypertension incidence rate of GDM group were higher than those women without GDM. GDM can increase the incidence of complications, such as:great children, neonatal hypoglycemia, neonatal asphyxia, neonatal hyperbilirubinemia, neonatal transfer neonatology treatment and perinatal death.3. Implementation of diet control and exercise therapy for pregnant women with GDM can reduce incidence rate of maternal and fetal complications, such as:preterm birth, cesarean delivery, polyhydramnios, gpregnancy induced hypertension, fetal distress, fetal growth restriction, postpartum hemorrhage, huge children, neonatal asphyxia, neonatal hyperbilirubinemia, neonatal transfer neonatology treatment and even perinatal death.