| OBJECTIVE:To investigate the correlation between first trimester erythrocyte parameters and gestational diabetes mellitus(GDM)and the predictive value of first trimester hemoglobin(HB)levels in GDM.Methods:1.Collection total 872 cases of single pregnancy women which have obstetric outpatient card and regular outpatient follow-up and a complete test reports from obstetrics and gynecology in our hospital from January 1,2013 to June 30,2013.As the inclusive criterion:① pregnant women can be collected which has complete examination,family history or treatment information.② After B-ultrasound,the patient were determined as single pregnancy.As the exclusion criterion:① pregnant women with diabetes before pregnancy,or other causes of elevated levels of diabetes in pregnancy period ② pregnant women with more than twin maternal,and a family history of diabetes,first trimester pregnancy anemia(HB<110g/L),the average volume of red blood cells<80f1 or previous with blood diseases.③ pregnant women suffering from other complications.2.All the subjects were recorded with age,weight,height,maternity,hepatitis B surface antigen,family history of first-degree relatives diabetes,previous history of disease and the first HB,RBC,HCT,MCV,MCHC,PLT test results.75g Oral glucose tolerance test(OGTT)was applied between 24-28 weeks,and the diagnostic criteria for GDM refer to the GDM diagnostic criteria recommended by the InternationalAssociation of Diabetic Pregnancy Study Group(IADPSG)in 2010:75 g OGGT,fasting blood glucose ≥5.1 mmol/L,1 hour ≥10.0 mmol/L,2 hours ≥8.5mmol/L.Any blood glucose abnormalities can be diagnosed as gestational diabetes,meanwhile it needs to exclude pre-pregnancy diabetes.Total 206 patients with GDM were selected with the average age(27.85 ± 3.44)years.3.Use SPSS17.0 statistical software to calculate the results of normal distribution data as X±s and non-normal distribution of natural logarithmic data,the compare test between groups was checked by t.Risk factors analysis was determined as multi-factor stepwise regression analysis;the receiver operating characteristic(ROC)curve evaluates the first trimester diagnostic value of HB for GDM.The difference has statistically significant only when P<0.05.Results:Total 872 pregnant women with single pregnancy were enrolled in this study.163 patients with GDM were screened,their average age was 27.85 ± 3.44 years,the weight gain was 16.77 ± 4.71kg,the increase of BMI during pregnancy was 6.14 ± 1.68 kg/m2,HB133.04 ± 7.39g/L,MCV93.07 ± 3.85f1,MCH31.34 ± 1.44pg,MCHC336.74 ± 6.82g/L,PLT214.85± 52.56×109,RBC4.40 ± 0.34×1012,HCT 0.41 ± 0.03%.The Non-GDM group has 709 cases,their average age was 26.90 ± 3.12 years,the weight gain of pregnancy was 13.95 ± 3.66kg,the increase of BMI during pregnancy was 5.38 ± 1.43kg/m2,HB121.13 ± 6.28g/L,MCV92.25 ± 5.54f 1,MCH 31.28± 4.79pg,MCHC335.83 ± 15.38g/L,PLT 200.62 ± 47.08×109,RBC3.90 ±0.36×1012,HCT 0.37 ± 0.03%.After an independent sample t test and compared with the control group,the increase of BMI,HB,PLT,RBC and HCT in the GDM group were significantly higher than those Non-GDM group with the Significant difference(P<0.05).Univariate analysis showed that the increase of BMI,HB,PLT,RBC and HCT could be the influencing factors of GDM(P<0.05).Use GDM as the dependent variable,A single factor analysis was performed with a variable of P<0.05:put the increase of BMI,HB,PLT,RBC and HCT into the multivariate logistic regression model.To investigate the effects of increase of age and BMI,even HB,PLT,RBC and HCT which impact on the incidence of GDM.The results showed that the increase of BMI,HB,RBC and HCT were the independent influencing factors of GDM(P<0.05).Further analyze the predictive value from first trimester pregnancy HB to GDM by ROC curve,and HB126.5g/L in first trimester pregnancy could be used as the critical value of predict GDM.Conclusion:1.The age,the increase of BMI,HB,RBC and HCT in 14 weeks of gestation was the independent influencing factors of GDM in last trimester pregnancy.2.First trimester pregnancy HB levels and gestational diabetes were positively correlated,and HB levels of first trimester pregnancy should be controlled below than 126.5 g/L,to reduce the risk of GDM. |
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