The Predictive Effect Of Indicators Related To Perinatal Health Care Card Of Pregnant Women On The Occurrence Of Gestational Diabetes Mellitus In Jiangbei Area Of Nanjing

Objective: The aim of the study was to explore the predictive effect of indicators related to perinatal health care card of pregnant women on the occurrence of gestational diabetes mellitus(GDM)in Jiangbei area of Nanjing,and provide scientific evidence for early prevention and intervention of GDM.Methods: This is a single center retrospective case-control study.Subjects in the study were the pregnant woman who registered and examined in early pregnancy in the department of gynecology and obstetrics from July 1st,2018 to December 31 st,2018.According to the results of 75 g oral glucose tolerance test(OGTT)at gestational age 24-28 weeks,the subjects were divided into GDM group and normal control group.The general information of pregnant women and the laboratory data in early pregnancy were collected.Single factor comparison was performed to determine the significance of differences between the indexes of two groups.Then the significant data were selected to be further analyzed by multivariate logistic regression analysis,so as to determine the risk factors for predicting the occurrence of GDM.Subsequently,receiver operating characteristic(ROC)curve was used to analyze the critical value of each risk factor for predicting the of risk of GDM.Then,according to these critical values,each continuous numerical variable would be transformed into a binary variable,which is appropriate for the further multivariate logistic regression analysis.Results: A total of 802 subjects were selected,and 618 pregnant women were finally included in the study.Among them,80 cases were diagnosed as GDM and divided into GDM group,the other 538 cases were divided into normal control group.Single factor analysis showed that the age,body mass index(BMI),number of deliveries and fasting blood glucose(FBG)of pregnant women in GDM group were higher than those in normal control group,and the difference was statistically significant(P <0.05);However,there were no significant differences in number of pregnancies,white blood cells,hemoglobin,albumin,alanine aminotransferase,aspartate aminotransferase,total bilirubin,creatinine and urea nitrogen in early pregnancy between the two groups(P≥0.05).Logistic regression analysis showed that the risk factors for predicting the occurrence of GDM were maternal age,BMI before pregnancy and FBG in early pregnancy(P<0.05);But the number of deliveries has not been shown to be a risk factor for GDM(P≥0.05).ROC curve analysis showed that the critical age of pregnant women for predicting GDM risk was 28.5 years old(P< 0.001);the critical value of GDM risk predicted by BMI before pregnancy was21.45kg/ ㎡(P=0.002);the critical value of FBG predicting GDM risk in early pregnancy was 4.765mmol/L(P=0.016).After variable conversion,the logistic regression analysis showed that the risk of GDM was 2.513 times higher in the pregnant women over 28 years old than in the pregnant women under 28 years old(OR=2.513,95% Cl: 1.528～4.130);the risk of GDM in pregnant women with BMI>21.4kg/ ㎡ before pregnancy was 2.536 times higher than that in pregnant women with BMI≤21.4kg/㎡ before pregnancy(OR=2.536,95% Cl:1.520～4.232);the risk of GDM in pregnant women with FBG>4.76mmol/L was 2.364 times higher than that in pregnant women with FBG≤4.76mmol/L(OR=2.364,95% Cl:1.446～3.864).Conclusion: The age of pregnant women,BMI before pregnancy and FBG in early pregnancy are likely to be the risk factors for predicting the occurrence of GDM,especially when the age of pregnant women is more than 28 years old,BMI before pregnancy is more than 21.4kg/ ㎡ or FBG in early pregnancy is more than4.76mmol/L.It is necessary to take effective interventions as early as possible to prevent GDM.