| Background: Gestational diabetes(GDM)is one of the major complications of perinatal women,which refers to the normal glucose metabolism before pregnancy and the decrease of glucose tolerance for the first time during pregnancy.The causes of GDM are diverse,including the health condition of the pregnant women and the social environment factors that can affect the occurrence of GDM in pregnant women,and the pathological mechanism of the disease and the outcome of the disease is also very complicated.GDM can increase the incidence and mortality of various complications of pregnant women and perinatal infants,and lead to adverse pregnancy outcomes,which seriously affect the health of mothers and infants.Therefore,it is particularly important to investigate the pregnancy outcome and related risk factors of GDM in the diagnosis and treatment of GDM.Objective: To explore the pregnancy outcome and related risk factors in GDM pregnant,in order to provide reference for clinical treatment of these diseases.Methods: 654 pregnant and parturient women who were treated in our hospital from January 2015 to December 2017 were selected as the research subjects,including GDM pregnant and no GDM pregnant women,with 327 cases in each group,as the experimental group and the control group.All pregnant women collected the clinical data at 6-8 weeks of pregnancy,including age,height,pre pregnancy body mass index(BMI),education level,residence,occupation,family history of diabetes,pregnancy,birth,bad pregnancy history and so on.50 g GCT screening and 75 g oral glucose tolerance test(OGTT)were performed at 24-28 weeks of gestation,and the results were recorded.The total weight gain,pre birth weight and pregnancy outcome of all pregnant women were recorded,including the amount of bleeding,delivery mode,amniotic fluid index,placental adhesion,postpartum hemorrhage,incision fat liquefaction,neonatal malformation,low weight infant,neonatal ischemic encephalopathy,neonatal pulmonary inflammation andneonatal asphyxia.The differences in the general demographic characteristics,pregnancy related indicators,pregnancy outcomes(pregnant women and newborns)in the experimental group and the control group were comparied,and to analyze the GDM production by single factor analysis,and then analyzed the risk factors of GDM.Results:1 In this study,15 pregnant women in the experimental group were not delivered in our hospital after diagnosis and treatment,so there was no pregnancy outcome related data,the other 52 cases of clinical data were incomplete,and 59 cases in the control group were not completely eliminated.Finally,this study included 528 medical records of pregnant women,of which 260 cases were in the experimental group.268 cases in the control group.2 During the period of January 2015 to December 2017,166 cases(5.69%)were GDM in 2918 pregnant women in 2015,207 cases(7.15%)were GDM in 3259 pregnant and parturient women in 2016(6.35%),and 238 cases(7.15%)were GDM in 3328 pregnant women in 2017.The incidence of GDM increased gradually from2013 to 2017(P<0.05).3 The proportion of pregnant women in the experimental group aged <36 years was 85.38%,which was less than 96.27% in the control group,while the proportion of pregnant women at >36 years old accounted for 14.62%,which was higher than that in the control group(3.73%)(P<0.01).In addition,the proportion of pregnant women with family history of diabetes in the experimental group was 17.69%,which was much higher than that in the control group(7.09%)(P<0.01).There was no significant difference in the place of residence,educational level and occupation between the 2 groups(P>0.05).4 Through comparison and analysis of the related indexes during pregnancy of pregnant women in the 2 groups,the results showed that the pregnant women in the experimental group were different in the terms of fetal times,birth times,pregnancy times,number of premature births,abortion times,BMI classification,BMI,weight gain during pregnancy,weight increase during pregnancy and amniotic fluid indexcomparied with the control group(P<0.01).5 This study recorded and counted the delivery and pregnancy outcome of pregnant and parturient women and neonates in the 2 groups.From the results,we can see that the incidence of preeclampsia,amniotic fluid pollution,postpartum hemorrhage,delivery mode,delivery mode,amniotic fluid index,amniotic fluid index,maternal hospitalization time,newborn weight,neonatal 1,5 mins Apgar score,neonatal hospitalization time,hospitalization expenses,fetal age,neonatal body weight score,new birth,pneumonia and neonatal malformation were found in the experimental group.There were significant differences in the incidence of preeclampsia,amniotic fluid pollution,postpartum hemorrhage,delivery mode,amniotic fluid index,maternal hospitalization time,newborn weight,newborn 1,5minApgar score,neonatal hospitalization time,hospitalization expenses,fetal age,neonatal weight division,neonatal prognosis,neonatal pneumonia,neonatal malformation and neonatal ischemia,sexual encephalopathy,neonatal asphyxia between the experimental group and the control group(P<0.01),However,there was no significant difference between the 2 groups in premature rupture of membranes,placental adhesion and liquefaction of incision fat(P>0.05).6 The multifactor analysis that affects the occurrence of GDM: age(β=0.456,P=0.001,95%CI=1.19-2.08),weight gain(β=0.712,P=0.001,95%CI=1.35-3.09),parity(β=2.458,P=0.019,95%CI=1.49-91.83),secondary production(β=1.005,P=0.017,95%CI=1.23-6.23),combined diabetes history(β=2.038,P=0.001,95%CI=2.24-26.28)is the independent cause of GDM.Conclusion: GDM increases the incidence of complications in pregnant women and perinatal infants and leads to the emergence of adverse pregnancy outcomes.Age,weight gain,parity,birth,and diabetes history are the independent factors that lead to the occurrence of GDM.Therefore,strengthening pregnancy weight management and preventive health care for pregnant women with high risk factors of GDM is beneficial to the health of the mother and the fetus.In view of the rising incidence of GDM and the high incidence of bad pregnancy outcome,it is necessary to pay attention to the diagnosis and treatment of GDM,collect the information aboutpregnant women comprehensively,improve the diagnosis and monitoring system of GDM,strengthen the diet control,exercise,drug treatment and fetal monitoring,and improve the diagnosis and treatment of GDM to the maximum extent,reduce the negative impact of GDM on family and society. |
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