| Objective:Collection of clinical data on pregnant women with gestational diabetes mellitus in an obstetric department of a top three hospital in Nanjing,analysis of risk factors for gestational diabetes mellitus,and the relationship between gestational diabetes and adverse pregnancy outcomes,providing references for eugenics and pregnancy,and for the prevention and treatment of pregnancy Period Strategy for Diabetes.Methods:1.With reference to other studies,a statistical table entitled "Risk factors for gestational diabetes and adverse pregnancy outcomes" was designed to record the natural and clinical data of pregnant women and their pregnancy outcomes.2.Using a non-matched case-control study,1,523 pregnant women who were admitted and delivered in the obstetrics department of a top three hospital in Nanjing from June 1,2017 to December 31,2017 were taken as the research objects,of which 286 were diagnosed with gestational diabetes as cases Group,the remaining 1,237 cases of non-gestational diabetes were considered as a healthy control group for a case-control study.3.An Excel table was used to establish the database,and SPSS 21.0 was used for statistical analysis and processing of the data.Measurement data are expressed as mean ± standard deviation(X±S),The t-test was used to compare the means between the two groups;count data is expressed as frequency or percentage(%),and comparison of rates is tested by χ2;P<0.05 indicates difference There was statistical significance.The single factor was tested by t test orχ2 test,and the multiple factors were analyzed by logistic regression analysis.The inclusion criterion was 0.05 and the exclusion criterion was 0.1.Results:1.This study collected a total of 1,523 in-patient pregnant women who were eligible in a top three hospital in Nanjing from June 1,2017 to December 31,2017.Among them,286 were diagnosed with gestational diabetes.The incidence rate is 18.8%,which is higher than the 2017 global average of 15%published by the International Diabetes Federation(IDF),indicating that the incidence of gestational diabetes in China is relatively serious.2.The mean age of the gestational diabetes group was 31.16±4.988 years,and the control group was 29.35±4.295 years;the pre-pregnancy weight of the gestational diabetes group was 60.40±10.52 kg,and the control group was 55.60±7.63 kg;It was 23.11 ± 3.77kg/m2,and the control group was 21.26±2.82kg/m2;the average weight gain during pregnancy in the gestational diabetes group was 12.63±5.61kg,and the non-gestational diabetes control group was 14.14 ±4.87kg.The gestational diabetes group’s age,pre-pregnancy weight,and pre-pregnancy BMI were all larger than those of the control group,while the weight gain value and increase range during pregnancy were smaller than those of the control group,and the differences were statistically significant(P<0.05).3.The composition ratio of gestational diabetes group aged over 30 years(54.9%)was significantly larger than the control group(40.2%)(P<0.05);the composition ratio of college education level(66.4%)in the gestational diabetes group was significantly smaller than that of the control group(66.4%).75.3%)(P<0.05);the average number of pregnancies,miscarriages,and births were higher in the gestational diabetes group than in the control group,and the differences were statistically significant;the composition ratio of the gestational diabetes group was more than 2(42.7%)Significantly higher than the control group(28.1%)(P<0.05);the composition ratio of 2 or more abortions(24.1%)in the gestational diabetes group was significantly larger than that in the control group(14.6%)(P<0.05);The composition ratio of more than two times(45.8%)was significantly higher than that of the control group(34.8%)(P<0.05);the composition ratio of family history of diabetes in the gestational diabetes group(12.6%)was significantly higher than that of the control group(3.6%)(P<0.05);the pre-pregnancy BMI greater than 24(32.5%)was significantly greater in the gestational diabetes group than in the control group(14.1%)(P<0.05).4.The proportion of cesarean section in the gestational diabetes group(36%)was significantly smaller than that in the control group(42%)(P<0.05);the composition ratio of the macrosomia in the gestational diabetes group was(10.5%)different from the control group(8.3%).There was no statistical significance(P>0.05);the preterm birth ratio(12.6%)in the gestational diabetes group was significantly greater than that in the control group(7.3%)(P<0.05);the eclampsia composition ratio in the gestational diabetes group was(2.4%)and the control There was no significant difference in the group(2.0%)(P>0.05);the composition ratio of polyhydramnios in the gestational diabetes group was(0.3%)and there was no significant difference in the control group(0.5%)(P>0.05);The diabetic component had intrauterine distress at birth(1.0%)and the control group(1.7%)had no significant difference(P>0.05).5.The univariate analysis showed that the gestational diabetes group and the control group had statistically significant risk factors for differences in pregnancy age,education,number of pregnancies,number of miscarriages,number of births,family history of diabetes,and pre-pregnancy BMI.Logistic regression analysis showed that the risk of GDM increased with age.Among them,pregnant women aged 30-35 years old are 1.2 times more likely to develop GDM than those younger than 30 years old(OR=1.200,95%CI:0.882-1.663);pregnant women older than 35 years old are at less than 30 years old 1.842 times(OR=1.842,95%CI:1.238-2.741)years of age;the greater the number of abortions,the greater the risk of GDM.Among them,the risk of GDM in 2-3 abortions is 1.445 times the risk of abortion ≤1(OR=1.445,95%CI:1.007-2.072).The risk of GDM in abortions more than 4 times is 3.6 times the risk of abortion ≤1(OR=3.600,95%CI:1.552-8.350);Overweight or obese women,with the increase of BMI before pregnancy,the risk of GDM increased.Among them,pregnant women with a BMI greater than 28 are 3.605 times more likely to develop GDM than pre-pregnancy BMI less than 24(OR=3.605,95%CI:2.077-6.258);having a family history of DM has a strong correlation with the occurrence of GDM,and its risk of disease It is 3.214 times of pregnant women without family history of DM(OR=3.214,95%CI:1.983-5.209).Correlation analysis of gestational diabetes and adverse pregnancy outcomes shows that preterm birth is positively correlated with gestational diabetes.There was a negative correlation between cesarean section and gestational diabetes,and the difference was statistically significant(P<0.05).Conclusion:1.Pregnancy age over 35 years old and BMI before pregnancy>24kg/m2 and two abortions and family history of diabetes are the risk factors for gestational diabetes.Among them,BMI before pregnancy has the greatest effect.2.The two adverse pregnancy outcomes of premature delivery and cesarean delivery were positively and negatively correlated with gestational diabetes,respectively.It is suggested that strengthening the education and family history investigation of pregnant women’s pre-and gestational diabetes-related knowledge can help prevent gestational diabetes and its adverse pregnancy outcomes. |
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