| Objective: Through the analysis of risk factors of gestational diabetes mellitus, as well as effect on the outcome of pregnancy, to provide a theoretical basis for early clinical prevention, diagnosis, intervention for gestational diabetes mellitus.Methods: 1038 cases of pregnant women which were collected from June 1 2013 to November 30 2013 in The Military General Hospital of Beijing PLA, were retrospectively analyzed, except for five cases of unnatural conception, six twins cases, four cases of hypertension before pregnancy, two kidney cases, five cases of cardiovascular disease, two cases of liver disease,two cases of diabetes mellitus, twenty-five cases of hypothyroidism, five cases of non-hospital check-ups during pregnancy,six cases of incomplete information, and ultimately included 965 cases of pregnant women. Cases were selected according to GDM diagnosis standard, all of the 125 cases of pregnant women were selected as case group, during the same period,all of the 840 cases of pregnant women who were not diagnosed GDM were selected as control group, case control study. Application SPSS17.0 statistical software was apllied to analyze two groups of maternal age, gravidity, parity, gestational weight and weight gain, pre-pregnancy body mass index, family history of diabetes, level of education, carrying cases of hepatitis B antigen, vaginal candida and other basic conditions and pregnancy outcome.Results: 1.For the detection rate of gestational diabetes mellitus, 125 cases of pregnant women were diagnosed gestational diabetes, the incidence rate was 12.95%. Where the 75 g OGTT fasting glucose 42 cases, accounting for 33.6%; 1 hour after oral glucoseglucose 50 cases, accounting for 40%; sugar two hours after taking glucose 47 cases, accounting for 37.6%. 2.As for the case and control groups pregnant women age, gravidity, parity pre-pregnancy body mass index, pregnancy weight and weight gain, family history of diabetes, vaginal candidiasis difference was statistically significant(P<0.05); educational level, B hepatitis surface antigen carried cases, the difference was not statistically significant(P>0.05). The univariate analysis of the significant factors included the assignment after unification Logistic regression model analysis, selection stepwise regression, GDM screening factors. Overweight or obesity, family history of diabetes, maternal age is a major risk factor for GDM. The incidence of overweight or obese is 8.554 times as high as the normal weight. For the family history of diabetes,the risk of GDM pregnant women is 3.171 times as high as the women without family history of diabetes.With the increase of pregnancy age, the risk of incidence of GDM increased by 1.098 times. 3.Two sets of pregnancy and childbirth complications were compared, with 140 cases of preterm labor, the total incidence rate of 14.51%, 27 cases of the experiment group(21.60%) while in the control group, there were 113 cases(13.45%); 67 cases of premature rupture of membrane, the incidence rate of 5.91%,however, there were 23 cases case group(18.40%), 44 cases were in the control group(5.24%); 29 cases of hypertensive disorders in pregnancy, the incidence rate of 3.01%, there were 10 cases in experiemnt group(8.00%), 19 cases were in the control group(2.26 %); polyhydramnios 13 cases, the incidence rate was 1.35%,however,the patient group 10 cases(8.00%), 3 cases were in the control group(0.36%); 36 cases of postpartum hemorrhage, the incidence rate was 3.73%, 15 cases of the case group(12.00 %),21 cases in the control group(2.50%);400 cases of cesarean section, cesarean section rate was 41.45%, 65 cases(52.00%) in experiment groupand 335 cases were in control group(39.88%), were statistically significant(P <0.05). 4.Comparison of two groups of general situation of perinatal: 493 cases of newborn were male, accounting for 51.09%,472 cases were female, accounting for 48.91%.Placental weight : the average weight of the case group was(578.19 ± 104.76) g, the average weight in the control group was(575.50 ± 79.00) g; umbilical cord length : the average length of the case group was(56.14 ± 9.38) cm, the average length of thecontrol group was(55.06 ± 9.34) cm, the differences were not statistically significant(P> 0.05). 5.Two perinatal outcomes were compared,with 142 cases was diagnosed fetal distress, the incidence rate was 14.72%, 29 cases were in the patient group(23.20%), in the control group, there were 113 cases(13.45%); 64 cases of fetal macrosomia, the incidence rate was 6.63%, 14 cases were in the patient group(11.20%) in the control group,there were50 patients(5.95%); mild asphyxia four cases, the incidence rate was 7.67%, 3 cases in the patient group(2.40%) in the control group,there was only 1 patients(0.12%), the difference was statistically significant(P <0.05). Two cases of fetal growth restriction, the incidence rate was 0.21%, while there was only1 cases(0.80%) in the patient group, there was 1 patients in the control group(0.12%); 10 cases of neonatal malformations, the incidence rate was1.04%, while there were2 patients in the patient group(1.60%),while there were 8 cases in the control group(0.95%), the results of P> 0.05, the difference was not statistically significant.Conclusions: 1.Gestational diabetes mellitus incidence rate was 12.95%, and it should be caused take seriously. 2.Maternal age, family history of diabetes, overweight or obese are the risk factors for GDM. 3.GDM compared with non GDM maternal in pregnant women, for the outcomes of pregnancy,such as the incidence of preterm labor, premature rupture of membrane, hypertensive disorders in pregnancy, polyhydramnios, postpartum hemorrhage, cesarean section, fetal distress, fetal macrosomia, there was statistically significant difference. 4.Strengthen pregnancy education, good pre-pregnancy preparation, enhance knowledge of nutrition balanced diet, early detection and intervention GDM during pregnancy to monitor the entire process, to improve pregnancy outcomes and improve maternal and child health. |
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