Preliminary Clinical Study On Related Factors Of Gestational Diabetes Mellitus

Objectives:This paper was aimed to discusse the related factors of gestational diabetes mellitus(GDM),meanwhile takes a retrospective analysis of the maternal and infant outcome of GDM.Through the study on related factors of GDM and maternal and infant outcome,it is expected to provide prenatal care guidance for clinical pregnant women.Methods:According to the new GDM diagnostic criteria developed by the International Association of Diabetes and Pregnancy Study Groups,the data of 184 women who were hospitalized in the obstetrical ward of Subei People’s Hospital of Jiangsu Province from October 2017 to February 2018 were collected by questionnaire and data review.Excluding those of multiple pregnancy,those with a history of hypertension,angiocardiopathy,hepatopathy,nephropathy or endocrine disease,and those taking drugs that may affect glucose metabolism and lipid metabolism during pregnancy,the maternal data were divided into two groups:the non GDM group(n1=108 cases)and the GDM group(n2=76 cases).All the pregnant women were examined regularly in Subei Hospital.75g oral glucose tolerance test(OGTT)was performed at 24 to 28 weeks of gestation or afterwards.The clinical data were complete and all parturients had single child born alive.The data of the subjects were analyzed retrospectively with SPSS 19.0 and EXCEL 2016 software,and single-factor and multi-factor logistic regression analysis was used to study the related factors of GDM.Results:In this study,the average ages of the subjects,the non GDM group and the GDM group were(28.82±3.84)years,(28.07±3.52)years and(29.88±4.04)years respectively.The mean weight gain at pregnancy termination of the subjects,the non GDM group and the GDM group were(14.97±5.03)kg,(14.80±4.60)kg,and(15.14±5.45)kg respectively.Those with age≥35 years,BMI>24 kg/m2,family history of hypertension or diabetes,multiple number of abortions(≥3),history of gestational diabetes mellitus,caesarean section,premature birth(<37 weeks),postpartum hemorrhage,macrosomia,asphyxia neonatorum(Apgar score<8),neonatal hypoglycemia or neonatal infections of the GDM group had higher prevalences than that of the non GDM group.According to statistical analysis,the differences of age,BMI,family history,abortion frequency,history of gestational diabetes mellitus,the way of termination of pregnancy,gestational age at termination of pregnancy,asphyxia neonatorum(Apgar score<8),neonatal hypoglycemia and neonatal infections had statistical significance(P<0.05),while the differences of educational level,smoking status,non-pregnancy and pregnancy weekly exercise,parity,weight gain at termination of pregnancy,neonatal weight or postpartum hemorrhage were not statistical significant(P>0.05).The multivariate binary logistic regression analysis showed that body mass index(BMI)was an independent risk factor for GDM.Conclusion:According to the clinical study on factors related to gestational diabetes mellitus based on small sample,we discover that age,family history,history of abortion,history of gestational diabetes mellitus(GDM),and most of all,BMI,have great influences on the occurrence of GDM.Through this study,we discoverd that those pregnant women with GDM had a higher risk of premature birth,caesarean section,asphyxia neonatorum(Apgar score<8),neonatal hypoglycemia or neonatal infections.We also discover that GDM has some affection on macrosomia or postpartum hemorrhage.Therefore,we suggest as follows:1.Have an appropriate-age pregnancy,and control weight before;2.Pay attention to contraception,prevent abortion due to unwanted pregnancy;3.Take OGTT test before repregnancy if have a history of GDM.4.strengthen the close monitoring of perinatal GDM pregnant women and foetuses,control the blood glucose,actively prevent and treat complications,make early prevention,early detection,early control,and early treatment,so as to reduce the risk of maternal and fetal complications and improve the maternal and infant outcomes.5.Attach importance to regular postpartum visit and OGTT review.This study suggests that by providing targeted pre-pregnancy or antenatal care guidance for those preparing for pregnancy or pregnant women,it is possible to reduce the incidence of GDM.The long-term effects of GDM on mother and child need to be confirmed in large numbers of multicenter prospective randomized controlled clinical trials.