Screening For Gestational Diabetes Mellitus And Associated Risk Factors

Objective: To investigate the incidence of gestational diabetes mellitus(GDM) in the Second Hospital of Sichuan University and explore the risk factors of GDM, and to follow up the 75 g oral glucose tolerance test (OGTT) in gestational diabetes mellitus (GDM) between 6-12weeks after birth for reclassifying and analyzing the risk factors associated with the abnormal blood glucose level.Material and methods:1. The clinical data of 3804 pregnant women who underwent the GCT from February 2006 to January 2007 in the Second Hospital of Sichuan University were collected, and a retrospective was made.2. We use single factor and multiple factor regression analysis on 241 pregnant women who were tested GDM in prenatal diagnosis and in obstetrics ward used as investigation object from April 2006 to December 2006, and select 239 healthy pregnant women who are synchronization childbirth used as control to study the effect between the mobility of GDM and every factor: age, stature, protestation body weight, ante partum body weight, pregnancy weight gain, protestation body mass index, ante partum body mass index, fasting total cholesterol (TC),triglyceride(TG),high-density-lipoprotein cholesterol (HDL-C) and low-density-lipoprotein cholesterol (LDL-C) , HBsAg(+)carrier and other factors. 198 cases out of 241 GDM underwent a 2 hours 75 g OGTT 6-12 weeks. We use the SPSS13.0 statistical software set to analyze the data.Results:1.3804 cases of GCT to screen GDM (1) The abnormal rate of GCT was 40.1% (1525/3804), 20.0%(305/1525) of were diagnosed as GDM and 17.9% of them were diagnosed as GIGT . The period prevalence of GDM was 8.0% and GIGT was 7.2% in our hospital. (2)There were no difference in GDM rate of abnormal GCT when GCT underwent during gestation. (3) The rate of abnormal GCT and the incidence of the GDM are obviously different among the different age groups.2.Multiple factor logistic regression analysis show pregnant women age,protestation body mass,ante partum body mass,pregnancy weight gain,high fasting triglyceride( TG),high fasting total cholesterol (TC ),DM family history and gestation times affect the morbidity of DM and have statistical significance. Fasting high-density-lipoprotein(HDL-C) andlow-density-lipoprotein cholesterol (LDL-C) may be the relative factors of GDM.2. Postpartum glucose (1) 198 cases out of 241 GDM have underwent the OGTT during 6-12 weeks after delivery . Among them, 126 cases (63.6 %) were normal , 57 cases (28.8 %) and 15 cases (7.6 %) were IGT and DM respectively .(2) In the DM group , 4 point- blood glucose values in OGTT were evidently higher than the other two groups( P<0.05) (3)Maternal age , body weight and family history did not show difference in the three groups.Conclusions:1.(1) The abnormal rate of GCT was 40.1%, 1/5 of were diagnosed as GDM and about 1/5 of them were diagnosed as GIGT . The period prevalence of GDM was 8.0% and GIGT was 7.2% in our hospital. (2)Age is the important risk factor for the GDM. It is better to screen GDM among the pregnant women older than 25 years old.2.Multiple factor logistic regression analysis show pregnant women age,protestation body mass,antepartum body mass,pregnancy weight gain,high fasting triglyceride( TG),high fasting total cholesterol (TC ),DM family history and gestation times affect the morbidity of DM and have statistical significance.3.Among the GDM who have underwent OGTT during 6-12 weeks after delivery , 28.8% were IGT and 7.6% were DM. The DM group showed high level of 4 point-glucose of OGTT during pregnancy. It is necessary to take a 2 hours 75 g OGTT 6-12 weeks Postpartum for the pregnant women with high level glucose of OGTT during pregnancy.