双胎妊娠合并妊娠期糖尿病的围产结局及相关危险因素分析
目的:探讨双胎妊娠合并妊娠期糖尿病（GDM）的围产结局，并分析双胎GDM发病的相关危险因素。方法:回顾性分析2015年1月至2020年6月在中山大学附属第三医院住院分娩的双胎妊娠孕妇757例，根据75 g口服葡萄糖耐量试验（OGTT）结果，分为双胎GDM组196例，正常双胎组（双胎未合并GDM）561例。收集各组母儿的临床资料、围产结局和新生儿结局，并采用 t检验、Mann-Whitney U检验、χ2检验或Fisher确切概率法比较，采用多因素logistic逐步回归分析评价双胎GDM发病的相关危险因素。 结果:双胎GDM组的75 g OGTT FPG、1 h血糖和2 h血糖均大于正常双胎组...
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| Published in | 中华糖尿病杂志 Vol. 13; no. 9; pp. 852 - 858 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
中山大学附属第三医院产科，广州 510630
27.09.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.cn115791-20201128-00692 |
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| Abstract | 目的:探讨双胎妊娠合并妊娠期糖尿病（GDM）的围产结局，并分析双胎GDM发病的相关危险因素。方法:回顾性分析2015年1月至2020年6月在中山大学附属第三医院住院分娩的双胎妊娠孕妇757例，根据75 g口服葡萄糖耐量试验（OGTT）结果，分为双胎GDM组196例，正常双胎组（双胎未合并GDM）561例。收集各组母儿的临床资料、围产结局和新生儿结局，并采用
t检验、Mann-Whitney
U检验、χ2检验或Fisher确切概率法比较，采用多因素logistic逐步回归分析评价双胎GDM发病的相关危险因素。
结果:双胎GDM组的75 g OGTT FPG、1 h血糖和2 h血糖均大于正常双胎组；双胎GDM组的分娩孕周、新生儿出生体重小于正常双胎组，<37周的早产率大于正常双胎组；双胎GDM组的新生儿呼吸窘迫综合征（RDS）、感染及贫血发生率大于正常双胎组，差异均具有统计学意义（均
P<0.05）。两组相比，年龄、孕前体重指数（Pre-BMI）、孕次、产次、体外受精-胚胎移植（IVF-ET）占比、绒毛膜性质、多囊卵巢综合征（PCOS）病史及糖尿病家族史差异均有统计学意义（均
P<0.05），将以上因素进行多因素的logistic逐步回归分析，显示年龄≥35岁（OR值为2.335）、Pre-BMI≥24.0 kg/m
2（OR值为2.356）、PCOS病史（OR值为1.932）、糖尿病家族史（OR值为3.127）是双胎GDM发病的独立危险因素（均
P<0.05）。
结论:双胎GDM增加了<37周的早产、新生儿RDS、感染及贫血发生率；年龄≥35岁、Pre-BMI≥24.0 kg/m
2、PCOS病史和糖尿病家族史是双胎GDM发病的独立危险因素。 |
|---|---|
| AbstractList | 目的:探讨双胎妊娠合并妊娠期糖尿病（GDM）的围产结局，并分析双胎GDM发病的相关危险因素。方法:回顾性分析2015年1月至2020年6月在中山大学附属第三医院住院分娩的双胎妊娠孕妇757例，根据75 g口服葡萄糖耐量试验（OGTT）结果，分为双胎GDM组196例，正常双胎组（双胎未合并GDM）561例。收集各组母儿的临床资料、围产结局和新生儿结局，并采用
t检验、Mann-Whitney
U检验、χ2检验或Fisher确切概率法比较，采用多因素logistic逐步回归分析评价双胎GDM发病的相关危险因素。
结果:双胎GDM组的75 g OGTT FPG、1 h血糖和2 h血糖均大于正常双胎组；双胎GDM组的分娩孕周、新生儿出生体重小于正常双胎组，<37周的早产率大于正常双胎组；双胎GDM组的新生儿呼吸窘迫综合征（RDS）、感染及贫血发生率大于正常双胎组，差异均具有统计学意义（均
P<0.05）。两组相比，年龄、孕前体重指数（Pre-BMI）、孕次、产次、体外受精-胚胎移植（IVF-ET）占比、绒毛膜性质、多囊卵巢综合征（PCOS）病史及糖尿病家族史差异均有统计学意义（均
P<0.05），将以上因素进行多因素的logistic逐步回归分析，显示年龄≥35岁（OR值为2.335）、Pre-BMI≥24.0 kg/m
2（OR值为2.356）、PCOS病史（OR值为1.932）、糖尿病家族史（OR值为3.127）是双胎GDM发病的独立危险因素（均
P<0.05）。
结论:双胎GDM增加了<37周的早产、新生儿RDS、感染及贫血发生率；年龄≥35岁、Pre-BMI≥24.0 kg/m
2、PCOS病史和糖尿病家族史是双胎GDM发病的独立危险因素。 |
| Abstract_FL | Objective:To explore the effects of gestational diabetes mellitus (GDM) on the perinatal outcomes in twin pregnancies, and analyze the risk factors of twin pregnancies complicated with GDM.Methods:Retrospective analysis was performed on 757 patients of twin pregnancies who had delivered in the Third Affiliated Hospital of Sun Yat-sen University during January 2015 to June 2020. According to the results of 75 g oral glucose tolerance test (OGTT), 196 cases were in the GDM group, and 561 cases were inthe non-GDM group. The clinical characteristics of the subjects were recorded, the perinatal outcomes of the two groups were compared by using
t test, Mann-Whitney
U test, χ
2 test or Fisher exact probability method;the risk factors related to GDM were analyzed by multivariate-logistic stepwise regression.
Results:Compared with the non-GDM group, 75 g OGTT-fasting plasma glucose (FPG), 1 h plasma glucose (PG), 2 h PG in GDM group were higher, gestational weeks and birth weight of newborn in GDM group were lower, the rate of preterm birth(<37 weeks) was higher. The incidence of neonatal respiratory distress syndrome, infection and anemia in the GDM group was higher than that in the non-GDM group (all
P<0.05). There were statistically significant differences in age, pre-pregnancy body mess index (pre-BMI), gravidity, parity, proportion of in vitro fertilization and embryo transfer (IVF-ET), chorionicity, polycystic ovary syndrome (PCOS) history and family history of diabetes (all
P<0.05). Risk factors were analyzed by multivariate-logistic stepwise regression, age ≥35 years (OR=2.335), pre-BMI ≥24.0 kg/m
2 (OR=2.356), PCOS history (OR=1.932) and family history of diabetes (OR=3.127) were independent risk factors for GDM in twin pregnancies (all
P<0.05).
Conclusions:GDM increased the incidence of preterm birth less than 37 weeks, neonatal respiratory distress syndrome, infection and anemia in twin pregnancies. Age ≥35 years, pre-BMI ≥24.0 kg/m
2, PCOS history and family history of diabetes were independent risk factors for GDM in twin pregnancies. |
| Author | 李玲 李萍 范建辉 崔金晖 陈新娟 欧阳丽萍 |
| AuthorAffiliation | 中山大学附属第三医院产科，广州 510630 |
| AuthorAffiliation_xml | – name: 中山大学附属第三医院产科，广州 510630 |
| Author_FL | Ouyang Liping Li Ping Li Ling Chen Xinjuan Cui Jinhui Fan Jianhui |
| Author_FL_xml | – sequence: 1 fullname: Cui Jinhui – sequence: 2 fullname: Li Ping – sequence: 3 fullname: Ouyang Liping – sequence: 4 fullname: Li Ling – sequence: 5 fullname: Chen Xinjuan – sequence: 6 fullname: Fan Jianhui |
| Author_xml | – sequence: 1 fullname: 崔金晖 – sequence: 2 fullname: 李萍 – sequence: 3 fullname: 欧阳丽萍 – sequence: 4 fullname: 李玲 – sequence: 5 fullname: 陈新娟 – sequence: 6 fullname: 范建辉 |
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| Keywords | 糖尿病，妊娠 Perinatal outcomes 危险因素 Diabetes, gestational 围产结局 Twin pregnancy 双胎妊娠 Risk factors |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitle_FL | Chinese Journal of Diabetes Mellitus |
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