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重庆市区23 896名孕妇妊娠期糖尿病发病现况及危险因素分析

曾晓玲,  何子翼,  周妮娅,  黄巧,  陈卿,  曹佳,  皮静波

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文章导航 > 中华疾病控制杂志  > 2023 >  27(1): 70-76
曾晓玲, 何子翼, 周妮娅, 黄巧, 陈卿, 曹佳, 皮静波. 重庆市区23 896名孕妇妊娠期糖尿病发病现况及危险因素分析[J]. 中华疾病控制杂志, 2023, 27(1): 70-76. doi: 10.16462/j.cnki.zhjbkz.2023.01.013
引用本文: 曾晓玲, 何子翼, 周妮娅, 黄巧, 陈卿, 曹佳, 皮静波. 重庆市区23 896名孕妇妊娠期糖尿病发病现况及危险因素分析[J]. 中华疾病控制杂志, 2023, 27(1): 70-76. doi: 10.16462/j.cnki.zhjbkz.2023.01.013
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ZENG Xiao-ling, HE Zi-yi, ZHOU Ni-ya, HUANG Qiao, CHEN Qing, CAO Jia, PI Jing-bo. The prevalence and risk factors of gestational diabetes mellitus among 23 896 pregnant women in Chongqing[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(1): 70-76. doi: 10.16462/j.cnki.zhjbkz.2023.01.013
Citation: ZENG Xiao-ling, HE Zi-yi, ZHOU Ni-ya, HUANG Qiao, CHEN Qing, CAO Jia, PI Jing-bo. The prevalence and risk factors of gestational diabetes mellitus among 23 896 pregnant women in Chongqing[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(1): 70-76. doi: 10.16462/j.cnki.zhjbkz.2023.01.013
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重庆市区23 896名孕妇妊娠期糖尿病发病现况及危险因素分析

doi: 10.16462/j.cnki.zhjbkz.2023.01.013
  • 1.

    110122 沈阳，中国医科大学公共卫生学院环境毒理学研究室

  • 2.

    400038 重庆，陆军军医大学(第三军医大学)军事预防医学系毒理学研究所

  • 3.

    400021 重庆，重庆医科大学附属妇女儿童医院质量管理科

  • 4.

    400021 重庆，重庆医科大学附属妇女儿童医院科教科

  • 5.

    400021 重庆，重庆医科大学附属妇女儿童医院妇产科

曾晓玲和何子翼为共同第一作者
基金项目: 

国家自然科学基金重点项目 82130097

重庆市技术创新与应用示范专项 cstc2018jscx-mszdX0021

详细信息
    通讯作者:

    曹佳，E-mail: caojia1962@126.com

    皮静波，E-mail: jingbopi@163.com

  • 中图分类号: R173

The prevalence and risk factors of gestational diabetes mellitus among 23 896 pregnant women in Chongqing

  • 1.

    Program of Environmental Toxicology, School of Public Health, China Medical University, Shenyang 110122, China

  • 2.

    Institute of Toxicology, Faculty of Military Preventive Medicine, Army Military Medical University (Third Military Medical University), Chongqing 400038, China

  • 3.

    Quality Management Department, Women and Children's Hospital of Chongqing Medical University, Chongqing 400021, China

  • 4.

    Department of Scientific Research and Education, Women and Children's Hospital of Chongqing Medical University, Chongqing 400021, China

  • 5.

    Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 400021, China

ZENG Xiao-ling and HE Zi-yi contributed equally to this work
Funds: 

National Natural Science Foundation of China 82130097

Chongqing Technology Innovation and Application Demonstration Project cstc2018jscx-mszdX0021

More Information

    摘要
  • 摘要:   目的  分析重庆市区2018-2021年孕妇妊娠期糖尿病(gestational diabetes mellitus, GDM)的发病现况及其相关危险因素，为GDM的防控提供依据。  方法  收集2018年1月-2021年6月在重庆医科大学附属妇女儿童医院进行产前检查的孕妇临床资料，并采用logistic回归分析模型分析不同危险因素对GDM的影响。  结果  本研究共纳入来自重庆市区23 896名孕妇为研究对象，确诊为GDM的患者有6 269例，占26.2%。2018-2021年GDM的发病率分别为27.3%、25.0%、26.4%和26.4%。多因素logistic回归分析模型分析结果表明，在调整相关变量之后，年龄(OR=1.47, 95% CI: 1.41~1.54, P < 0.001)、BMI (OR=1.74, 95% CI: 1.65~1.83, P < 0.001)和内分泌疾病史(OR=9.32, 95% CI: 8.68~10.01, P < 0.001)是导致GDM患病风险增加的危险因素。  结论  本研究发现重庆市区GDM的发病率较高，且高龄孕妇、孕前超重或肥胖和内分泌疾病史是GDM的高危因素。重庆市区应加强系统性的产科护理，关注孕期这些危险因素的变化，以减少GDM的发生。
    Abstract:   Objective  To analyze the changes in the morbidity gestational diabetes mellitus (GDM) and related risk factors in Chongqing from 2018 to 2021, and provide evidence for prevention and control of gestational diabetes mellitus.  Methods  Clinical data of pregnant women who attended prenatal care in Women and Children's Hospital of Chongqing Medical University from January 2018 to June 2021 were collected, and 6269 pregnant women were diagnosed with GDM. The incidence of GDM and risk factors were investigated. The multivariate logistic regression was used for statistical analysis.  Results  A total of 23 896 subjects were included in this study. There were 6 269 pregnant women with GDM, with a ratio of 26.2%, and the incidence rates of GDM in pregnant women from 2018 to 2021 were 27.3%, 25.0%, 26.4%, and 26.4%, respectively. Multivariate logistic regression analysis showed that age (OR=1.47, 95% CI: 1.41-1.54, P < 0.001), BMI (OR=1.74, 95% CI: 1.65-1.83, P < 0.001) and history of endocrine disease (OR=9.32, 95% CI: 8.68-10.01, P < 0.001) were risk factors of GDM.  Conclusions  The incidence of GDM is relatively high in Chongqing, and advanced maternal age and pre-pregnancy overweight or obesity are high risk factors for GDM. Systematic obstetric care should be intensified in Chongqing and more attention should be paid to changes of these risk factors during pregnancy to reduce the occurrence of GDM.
    • HTML全文

  • 图  1  研究对象纳入流程

    Figure  1.  The process of inclusion of research subjects

    下载: 全尺寸图片 幻灯片

    图  2  2018-2021年重庆市区GDM的年均发病率

    Figure  2.  The annual incidence of GDM in Chongqing City from 2018 to 2021

    下载: 全尺寸图片 幻灯片

    图  3  2018-2020年重庆市区各区域GDM的年均发病率

    Figure  3.  Annual incidence of GDM in Chongqing from 2018 to 2020

    下载: 全尺寸图片 幻灯片

    表  1  研究对象的基线特征[n(%)]

    Table  1.   Baseline characteristics of study subjects [n(%)]

    变量 2018年 2019年 2020年 2021年 合计 H/χ2值 P值
    年龄(岁) 616.54 < 0.001
         < 35 4 557(62.6) 5 430(68.5) 5 137(74.3) 1 401(83.8) 16 538(69.2)
        ≥35 2 723(37.4) 2 495(31.5) 1 775(25.7) 270(16.2) 7 358(30.8)
    BMI (kg/m2) 85.89 < 0.001
         < 25 5 550(82.9) 6 198(83.1) 5 590(85.9) 1 414(79.5) 18 739(83.9)
        ≥25 1 143(17.1) 1 262(16.9) 917(14.1) 365(20.5) 3 592(16.1)
    孕次(次) 12.32 0.006
        1 2 353(32.3) 2 588(32.7) 2 338(33.8) 617(34.8) 7 896(33.1)
        2 1 966(27.0) 2 169(27.4) 1 918(27.8) 498(28.1) 6 551(27.4)
        ≥3 2 961(40.7) 3 165(40.0) 2 651(38.4) 658(37.1) 9 435(39.5)
    产次(次) 5.58 0.134
        0 4 589(63.0) 5 008(63.2) 4 352(63.0) 1 069(60.3) 15 018(62.9)
        ≥1 2 691(37.0) 2 914(36.8) 2 556(37.0) 704(39.7) 8 865(37.1)
    吸烟史 27.85 < 0.001
        是 157(2.3) 277(3.5) 217(3.2) 35(2.0) 686(2.9)
        否 6 801(97.7) 7 579(96.5) 6 631(96.8) 1 729(98.0) 22 740(95.2)
    饮酒史 250.79 < 0.001
        是 680(9.4) 1 426(18.3) 1 074(15.8) 240(13.6) 3 420(14.5)
        否 6 527(90.6) 6 359(81.7) 5 717(84.2) 1 521(86.4) 20 124(85.5)
    是否服用叶酸 1 105.12 < 0.001
        是 6 572(90.3) 7 786(98.5) 6 860(99.7) 1 738(98.8) 22 956(96.4)
        否 703(9.7) 116(1.5) 24(0.3) 21(1.2) 864(3.4)
    内分泌疾病史 56.53 < 0.001
        是 1 782(24.5) 1 657(20.9) 1 787(25.9) 449(25.2) 5 675(23.7)
        否 5 498(75.5) 6 268(79.1) 5 125(74.1) 1 330(74.8) 18 221(76.3)
    多胎妊娠 8.69 0.034
        是 349(4.8) 368(4.6) 266(3.8) 77(4.3) 1 060(4.4)
        否 6 931(95.2) 7 557(95.4) 6 646(96.2) 1 702(95.7) 22 836(95.6)
    巨大儿分娩史 27.14 < 0.001
        是 9(0.1) 3(0.0) 26(0.4) 2(0.1) 40(0.2)
        否 7 271(99.9) 7 922(100.0) 6 886(99.6) 1 777(99.9) 23 856(99.8)
    辅助生殖 10.20 0.017
        是 609(8.4) 639(8.1) 484(7.0) 135(7.6) 1 867(7.8)
        否 6 671(91.6) 7 286(91.9) 6 428(93.0) 1 644(92.4) 22 029(92.2)
    下载: 导出CSV

    表  2  单因素和多因素logistic回归分析模型分析不同危险因素对GDM发病的影响

    Table  2.   Univariate and multivariate logistic regression analysis of the effects of different risk factors on the incidence of GDM

    变量 OR(95% CI)值 P值 变量 OR(95% CI)值 P值
    单因素logistic回归 单因素logistic回归
        年龄(岁) 1.53(1.44~1.62) < 0.001     巨大儿分娩史 0.82(0.39~1.72) 0.059
        BMI (kg/m2) 1.74(1.62~1.88) < 0.001     辅助生殖 0.83(0.74~0.93) 0.001
        孕次 0.99(0.93~1.05) 0.708 多因素logistic回归
        产次 0.97(0.91~1.03) 0.246     年龄(岁) 1.47(1.41~1.54) < 0.001
        吸烟史 1.13(0.96~1.34) 0.150     BMI (kg/m2) 1.74(1.65~1.83) < 0.001
        饮酒史 0.95(0.87~1.03) 0.193     是否服用叶酸 0.81(0.68~0.97) 0.019
        是否服用叶酸 0.81(0.70~0.94) 0.005     内分泌疾病史 9.32(8.68~10.01) < 0.001
        内分泌疾病史 8.71(8.15~9.31) < 0.001     多胎妊娠 1.19(1.00~1.43) 0.056
        多胎妊娠 0.84(0.73~0.98) 0.022     辅助生殖 1.06(0.92~1.21) 0.460
    下载: 导出CSV
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  • 收稿日期:  2022-05-13
  • 修回日期:  2022-07-03
  • 网络出版日期:  2023-02-09
  • 刊出日期:  2023-01-10

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