Study On Risk Factors And Pregnancy Outcome Of Gestational Diabetes Mellitus

Objective: To investigate the incidence of gestational diabetes mellitus(GDM) in in-patient and the influence on pregnancy outcome of GDM, and explore the associated factors and the extent of their influences on GDM.Methods: A random sampling method was used in this study. 235 GDM women were investigated from January, 2004 to December, 2008 who deliveryed in the Xiangya Second Hospital of central south University, and 261 without GDM women who are synchronization childbirth used as control .We analysis on general character of two group and the effect between the mobility of GDM and every factor such as family history with DM, child-bearing history, pregnancy complication, baseline body mass index(BMI), duration weight gain of pregnancy, amniotic fluid index(AFI), postpartum blood loss, delivery mode, and the Apgar score, complication, prognosis of neonate. The Statistical Package for Social Science (SPSS) 16.0was used for the descriptive analysis of ANOVA, t-test, chi-square, U test, Logistic stepwise regression.Results:1. The incidence of gestational diabetes mellitus(GDM) in in-patient was 4. 24 percent and the trend is raising by years.2. The results of 2 samples t-test on child-bearing history showed that the times of pregnancy, abortion, premature delivery, term delivery, twin pregnancy and survival rat were of statistical significance between the GDM group and the control group (P<0.01) .3. The analysis of the postpartum blood loss, the fare of cure, the Average Length of Stay in GDM group were significantly higher than control group and the neonatal weight, Apgar score were lower in GDM group. The results of Chi-square on GDM and control group indicated that the women of GDM has higher rate of ceasarean , premature delivery, neonatal leipothymia, neonatal pneumonia , hypoxic-ischemic encephalopathy, neonatal macrosomia, low-birth-weight infant than control group (P<0.001). But the neonatual jaundice between GDM and control group has not statistical significance (P>0.05) .4. The results of logistic regression analysis indicated that twin pregnancies, family history, baseline BMI, times of delivery, duration weight gain of pregnancy, age, education were the main factors related to GDM. Their logistic coefficients were 2.384,2.068,1.087,1.007,0.709,0.455,-0.209 respectively. Among them, the most influencing factor was twin pregnancies.Conclusions:1 .The incidence of gestational diabetes mellitus(GDM) in in-patient was 4.24 percent and the trend is raising by years.2.Women with GDM had more postpartum blood loss and had a high frequency of polyhydramnios, oligohydramnios, cesarean section, complications and increased fare of cure and the average length of stay compared with women without GDM.3. Women with GDM had high risk of neonatal macrosomia, low-birth-weight infant, premature delivery, neonatal leipothymia, perinatal mortality, neonate in NICU, neonatal pneumonia , hypoxic-ischemic encephalopathy compared with women without GDM, But the neonatual jaundice between GDM and control group has not statistical significance.4. The main influencing factors of GDM were twin pregnancies, family history, baseline BMI, times of delivery, duration weight gain of pregnancy, age, education.