| Objective:To explore the incidence of Gestational Diabetes Mellitus (GDM) in Jining district, analyze etiology of GDM, and discuss the effects of different interference methods on pregnancy outcome during pregnancy.Methods:Statistics of the total number of hospitalized pregnant women as well as the annual number of GDM patients from the Affiliated Hospital of Jining Medical College hospital from 2009 to 2013. Retrospective analysis of all 979 medical record cases of GDM patients in the last 5 years; the analyzing includes age, Pregnancy history, family history, drug intervention and so on. All 290 medical record cases of GDM during 2013 were extracted, and 300 cases of hospitalized pregnant women with normal glucose tolerance in 2013 were set as a control group. Data of age, pre-pregnancy height, pre-pregnancy weight, maternal weight, number of pregnancies, the number of births, maternal fundal height, maternal abdominal circumference, family history of diabetes, history of huge child labor and so on were collected for comparison analysis. There are in total 496 pregnancies medical examination and GDM cases from 2012 to 2013, which were divided into 3 groups according to medical interference during pregnancy. Those 3 groups are:289 cases of diet control, 118 cases of diet control with insulin interference, and 89 cases of non-interference. These pregnancy outcomes from 3 groups were then statistically analyzed.Results:1. During 2009 to 2013, there had been 37186 of pregnant women who gave births at Affiliated Hospital of Jining Medical College. Numbers of childbirth in each year are 3868,4371,6916,10722 and 11309 respectively. And the GDM cases among them are 34,47,150,285 and 463. From 2009 to 2013, the incidences of GDM in this region are 0.88%,1.08%,2.17%,2.66% and 4.09%, which show an uprising trend. The average age was reduced from 31.24 to 29.98, and there is no statistical significance among people with pregnancy history, cesarean section rate or family history. Interference methods against GDM have been changed; increasing number of pregnant women used diet to control blood sugar, while fewer people applied insulin year by year.2. Univariate analysis of continuous variables:the pre-pregnancy BMI from GDM group and control group are (29.68±5.25) and (28.98±4.52) kg/m2; GDM shows lower pre-pregnancy BMI compared to control group, and that is statistically significant; the fundal height from GDM group and control group are (36.45±4.70) and (35.39±2.54); the abdominal circumference from GDM group and control group are (105.65±12.12) and (102.73±7.06); GDM shows higher value than control group, and that is statistically significant (P<0.05). These two groups show no statistically significance in age, pregnancy BMI value added, number of pregnancies and number of births. Univariate analysis for categorical variables:GDM and control group show statistically significances in family history and huge child history (P<0.05). As the result of multivariate Logistic regression analysis shows,5 parameters were included into this model, which were maternal body mass index, fundal height, abdominal circumference, huge child history and DM family history. As a result, high pre-pregnancy BMI, family history, huge child history, fundal height and abdominal circumference are risk factors for GDM (P<0.05).3. In diet control group, the average birth weight is 3516.92±625.44; in diet with insulin interference group, the average birth weight is 3397.71±708.75; in non-interference group, the average birth weight is 3515.06±714.33. No statically significance has been shown among birth weight from GDM patients among these 3 groups. Compared to non-interference group, diet control group exhibits remarkable reduction of premature birth incidence, and the difference shows statically significance (P<0.05). Compared with non-interference group, diet with insulin interference group illustrates strongly decline in premature rupture of membrane incidence and increase in fetal distress incidence, these differences show statically significance (P<0.05). Diet control group has lowered the incidence of cesarean section and premature birth when compared to diet with insulin interference group, and the difference shows statically significance (P<0.05).Conclusion:From 2009 to 2013, the DGM incidence has shown a rising trend year by year, and it is now 4.09%; high pre-pregnancy BMI, family history, huge child history are risk factors of GDM; diet control during pregnancy reduces the chance of cesarean section and premature birth. |
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