目的: 探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的影响因素,为GDM预防提供理论支持。方法: 收集2010年3月至2016年3月期间收治的92例GDM产妇及同期184例健康产妇的相关资料,进行单因素、多因素Logistic回归分析,分析人口学特征、行为习惯等与GDM发病的关系,并对比分析两组妊娠结局。结果: 多因素Logistic回归分析显示:孕妇年龄[暴露比值比(OR)1.7,95 %可信区间(CI)1.1-5.4]、孕期增重(OR 1.8,95% CI 1.1-6.6)、孕前BMI(OR 2.0,95% CI 1.05-5.3)、流产次数≥2次(OR 3.5,95% CI 2.7-21.4)、糖尿病家族史(OR 2.6,95% CI 2.0-14.9)、高血红蛋白血症(OR 2.7,95% CI 1.7-7.7)、喜食甜食(OR 5.0,95% CI 3.2-15.6)为GDM的独立危险因素(P＜0.05),其中日运动量≥1 h(OR 45,95% CI 2.1-14.7)为保护因素(P＜0.05);GDM组剖宫产、早产、妊高症、巨大儿、新生儿转儿科的比例高于健康对照组(χ²_剖宫产=4.010,P＜0.05;χ²_早产=5.4351,P＜0.05;χ²_妊高症=10.276,P＜0.01;χ²_巨大儿=4.280,P＜0.05;χ²_{新生儿转儿科}=12.041,P＜0.01)。结论: GDM的发病是多种危险因素共同作用的结果,并可导致多种不良妊娠结局,产科应加强GDM预防及干预。

Objective: To investigate the affecting factors about the morbidity of gestational diabetes mellitus (GDM), and to put forward its preventive measures.Methods: The relevant information of 82 cases of GDM and 184 cases of healthy pregnant from March 2010 to March 2016 were collected. The univariate and multivariate Logistic regression was used to analyze the demographic characteristics, behavior customs and the relationship with GDM, and the pregnant outcomes were compared between the two groups.Results: Multivariate Logistic regression analysis showed that: the age(OR 1.7,95 % CI 1.1-5.4), weight gained (OR 1.8,95 % CI 1.1-6.6), pre-pregnancy BMI(OR 2.0,95 % CI 1.05-5.3), more than 2 times of abortion(OR 3.5,95 % CI 2.7-21.4), a family history of diabetes(OR 2.6,95 % CI 2.0-14.9), hyperhemoglobinemia(OR2.7,95 % CI 1.7-7.7), and sweet tooth(OR 5.0,95 % CI 3.2-15.6) were the independent influencing factors for GDM (P＜0.05), whereas exercise more than 1 hours daily(OR 4.5,95 % CI 2.1-14.7) was a protective factor (P＜0.05). The proportions of cesarean section,premature birth,PIH,macrosomia and neonatal transfer to pediatrics in GDM-group were higher than those in healthy group(χ²_{cesarean section}=4.010,P＜0.05;χ²_{premature birth}=5.4351,P＜0.05;χ²_PIH=10.276,P＜0.01;χ²_Macrosomia=4.280,P＜0.05;χ²_{neonatal transfer to pediatrics}=12.041,P＜0.01).Conclusion: The morbidity of GDM is influenced by various factors, and can result in varied bad pregnancy outcomes. Prevention and intervention for GDM should be intensified in obstetrics.