| Background：The IADPSG panel suggest in2010that the hyperglycemia during gestationshould include the overt diabetes during pregnancy and the Gestational diabetesmellitus,the former refers to the diabetes which can obviously lead to the adversepregnant outcomes,regardless of whether it exist clinical symptomes, means that thehyperglycemia found during the gestation has reached to the diagnostic criteria of DM;Gestational diabetes mellitus refers to the sugar metabolic disorder occurred or beenfound in pregnancy which usually occurs in middle-late pregnancy.Domestic andforeign researches suggest that whether the pregnant women has been diagnosiseddiabetes mellitus or not, the higher their blood sugar levels, the higher the newbornhealth risk and its prevalence is increasing year by year. The professor L.Guariguata’sstudy in2013indicated that the prevalence of high glucose level during pregnanceamong all the women aged20-49was16.9%.The above data are creepy,consideringthat the severe complications,the effects to the maternal and child health and the greateconomic and mental burden to the society and family of the high glucose levelduring the pregnance,it has been payed more and more attentions from domestic andforeign researchers major in perinatal period. Thus,probe one or more inspectionmethods which can preferably anticipate the high glucose during the pregnance or candiagnose the high glucose during the pregnance earlier,has become a research hot potin the area of eugenic.At present,there is less researches on the GDM or the high glucose level during the pregnance among the minority nationality regions both indomestic and foreign countries. Lian Nan Yao Autonomous County is the onlylocalities of eight rows Yao nationality in china which has a Yao nationalitypopulation of50.73%,this special conditions has provided us a good requirement tostudy the high glucose level during the pregnance among the Han and Yao nationalitypregnant women,then,the Ethnic differences will also be discussed,which all of thesewill provide the fundamental conditions for the following research of minoritynationality,also,the eugenic work in the minority nationality regions can be improved.Objective：A screening for the overt diabetes during pregnancy and GDM among thepregnant women will be held in the Lian Nan Yao Autonomous County,therelationship between the AHSG and the high glucose level will be studied,thecomparison between the AHSG and other traditional indicators will be observed, atthe same time,the relationship between these indicators and the pregnant outcomeswill be detected,the National differences will also be discussed,which are convenientfor the establishment of a predictive index for the prediction of the high glucose levelduring pregnance and adverse pregnancy outcomes,then,we can lay a foundation forthe eugenic work in the minority nationality regions.Methods：1The FBG and HbA1C would be detected among the Han and Yao nationalitypregnant women who has fist attendant in the Lian Nan Yao Autonomous Countyhospital outpatient during January and December in2011, the overt diabetes duringpregnancy would be first found,then,the50g diabetes screening experiment would beheld among the other women, the screening positive rate will be firstlyinvestigated.The Intervention guide and telephone follow-up would be carried outamong the pregnant women with hyperglycemia. 2776cases inpatient pregnant women in labor with the gestational weeks at38~41will be carried out retrospective analysis,the they will be divided into two groupsaccording to blood glucose:high glucose level group and normal control group,therelationship between the glucose level in the late pregnance and the pregnancyoutcomes will be preliminary analyzed;Then,the samples will be divided into twogroups according to the nationality:Han nationality group and Yao nationalitygroup,and the ethnic differences between groups will also be analyzed.390cases in the early and mid trimester of pregnancy were extracted from allthe samples(gestational weeks7~22w), the serum AHSG level will be detected withELISA method. Every pregnant women participate in this study will be conducted thefollowing detections: fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc),BMI et al,with the basic informations and pregnancy outcomes,the database will beestablished,finally, there were74cases have been extracted to the study,therelationship among the serum AHSG,the glucose level in the late pregnance and thepregnancy outcomes will be studied,at the same time, the ethnic differences betweengroups will be researched.Results：1Finally,220cases incorporated in the study,19cases of the pregnant womenhave the screening positive,which included13cases of Han nationality and6cases ofYao nationality. The screening positive rate of diabetes during pregnant women inLian Nan Yao Autonomous County is8.64%,the positive rate during the pregnantweeks in24~28is5.41%, the morbidity of GDM in Lian Nan Yao AutonomousCounty is3.18%,and the high glucose level during pregnance is7.27%,there is noethnic differences between the Han and Yao pregnant women. The probability ofadverse pregnancy outcomes will be decresed if the women with the positive sceenand the high glucose level during the pregnant had recived the reasonable guidanceand intervene.2The elevated fasting glucose before delivery can lead to abnormal pregnancy outcome (P <0.05), there is no national differences (P>0.05) between the Han andthe Yao group.3The Standardized AHGS level correlated significantly with the pregnancyoutcomes (r=0.283, P=0.283), it has nothing to do with FBG before delivery,national and age.We regard the AHSG mean value of all the samples as the point ofthe contact,then we divided the cases into two groups according to the serumAHSG:the high level AHSG and the normal group,there is significant difference aboutthe pregnancy outcomes between the two groups(P=0.007).Conclusion：1The screening positive rate，the morbidity of GDM,the rate of hyperglycemiaamong the pregnant women in Lian Nan Yao Autonomous County was lower thanother places, there was no ethnic differences between the Han and Yao pregnantwomen.It was necessary to give the reasonable guidance and intervene to thepregnant women with the screening positive and hyperglycemia.2The elevated fasting glucose before delivery can lead to abnormal pregnancyoutcome, there is no national differences between the Han and the Yao group.3The Standardized AHGS level correlated significantly with the pregnancyoutcomes and has nothing to do with FBG before delivery.So we can not draw theconclusion that the serum AHSG can effect the pregnant outcomes by changing theglucose level of the late trimester of pregnance.However we may can regard theindictor as a predictor of the abnormal pregnancy outcomes and then make guidancefor early prevention of adverse pregnancy outcomes. |
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