| Objective: The epidemiological study of gestational diabetes mellitus(GDM) in a hospital in Changchun City was carried out to analyze the incidence, trend and influencing factors of diabetes mellitus in pregnant women in this area, and to provide the therapeutic strategy basis for the study of GDM.Method: A case control study was used, and a questionnaire survey was carried out. Physical condition, physical examination, biochemical examination, mode of delivery, neonatal birth weight, Apgar score and other data were analyzed.We use Excel software to establish a database and use SPSS18.0 to analyze the data. Using mean and standard deviation to represent the count data, using the composition ratio to represent the measurement data. Using Chi square test to compare between the rates.Test level is a =0.05, the application of Logistic method analysis the factors, inclusion criteria 0.05 and exclusion criteria 0.1.Result: 1. The study subjects were 1062 cases, mean age was 29.6±4.6 years old, 511 cases were in GDM, the mean age was 30.7±4.5 years old, 551 cases was not gestational diabetes mellitus(NGDM), the average age was 28.5±4.5 years old. The weight and age of GMD and non diabetes group were statistically significant differences(P<0.05), no significant difference(P>0.05) with height and culture. The age and body weight of GDM were greater than those in the NGDM. 2. The frequency of birth and pregnancy between GDM and NGDM pregnancy had significant difference(P<0.05),the number of pregnancies in the GDM was higher than that in the NGDM;There were statistically significant differences in systolic blood pressure between the two groups(P<0.05).There was no statistical difference in diastolic blood pressure(P>0.05).The systolic blood pressure of the GDM was higher than that in the NGDM; In the two groups, there were significant differences(P<0.05) in serum lipids(TG) and high density lipoprotein, and the GDM was higher than that in the NGDM. 3. The delivery methods of GDM and NGDM had statistically significant(P<0.05), GDM cesarean section ratio(70.1%) was higher than that of NGDM(53.6%).In the gestational weeks, there were statistical differences between the two groups(P<0.05), NGDM(39.6±14.3 weeks) was higher than that of GDM(36.9±8.7 weeks);The neonatal length of GDM(50.5±1.2cm) was higher than that of NGDM(50.1±1.0cm); The Apgar score(1 minutes) of GDM and NGDM were 8±0.4 points and there was no statistical difference(P>0.05).The Apgar score(5 minutes) were 8.7± 0.5 and 8.8±0.5, the difference was not statistically significant(P>0.05);here were no significant differences in the number of birth weight of GDM and NGDM in women(P>0.05). The newborn body weight is divided into low body weight, normal weight and large children were compared, had huge statistical significance(P<0.05),the composition ratio of GDM(17.7%) was higher than that of NGDM(7.4%). 4. Factors related to gestational diabetes mellitus were analyzed by single factor analysis. Between GDM and NGDM, the results showed that age, BMI, tc, pregnant times,the mode of delivery, systolic blood pressure, triglyceride and high density lipoprotein decreased. The difference was statistically significant above all the factors mentioned(P<0.05), multivariate logistic regression analysis showed that age, BMI, mode of delivery, elevated systolic blood pressure, elevated triglyceride and high-density lipoprotein(HDL) were significantly associated with gestational diabetes mellitus(GDM), which were statistically significant(P<0.05). Pregnancy times were not associated with gestational diabetes mellitus(P>0.05).After adjusting for other risk factors, age greater than 35 years the incidence of GDM is 1.559 times the age of 18~35(P<0.05, 95%CI:1.031~2.358),The risk of BMI is more than 28 of pregnant women for GDM is 1.459 times that of BMI(P<0.05,95%CI:1.105~1.927).The side cutting delivery and vaginal delivery of the OR value is 0.493(P<0.05,95%CI:0.303~0.804) and 0.319(P<0.05,95%CI:0.104~0.979). The OR values of elevated systolic blood pressure, elevated triglyceride and high density lipoprotein were2.636(P<0.05,95%CI:1.864~3.726)?1.947(P<0.05,95%CI:1.298~2.922)? 1.524(P<0.05,95%CI:1.154~2.014).Conclusion: 1. Age, BMI,the mode of delivery and elevated systolic blood pressure, elevated triglyceride and high-density lipoprotein decreased with gestational diabetes mellitus was statistically significant. 2. Old age, high BMI, blood pressure and blood lipid abnormalities were the risk factors of gestational diabetes mellitus. 3. The lateral incision delivery and vaginal delivery are protective factors of patients with gestational diabetes. 4. Culture, pregnancy time, prenatal examination time, diastolic blood pressure, cholesterol and low density lipoprotein were not associated with gestational diabetes mellitus. 5. Gestational diabetes mellitus had a high risk of producing giant babies,either of choosing the way of midwifery. |
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