| Objective:(1) To understand the development of gestational diabetes of type 2 diabetes in long-term by post-natal follow-up gestational diabetes wemen;(2)Using multivariate logistic regression analysis of non-condition to find risk factors for development of mellitus type 2 diabetes from pregnant women with gestational diabetes in long-term;(3)To Study the necessity whether GDM women should to be followed up for 42 days postpartum;(4) Explore the value of the latest diagnostic gestational diabetes mellitus in the Chinese clinical diagnosis;Methods:1)To analyze the medical record materials of 502 pregnant women who examined and had childbirth in the First Affiliated Hospital of AnHui Medical College and who were dignosed as gestional diabetes mellitus from April,2004 produces to April,2010.Total of 417 cases with integrated medical records of pregnant women rolled in analysis,in which,of 254 was in the final follow-up succeeded. We randomly selected some pregnant women without GDM at the same age in the same period of pregnancy for postpartum follow-up synchronization,,and ultimately follow-up of 148 cases successfully.2)In the 254 patients who were followed up, 98 cases of the abnormal glucose metabolism occurred postpartum as the study group, 156 patients with normal glucose metabolism as a control group. We recorded the patients'age, weight, family history of diabetes, OGTT results, blood lipids, blood pressure etc, We also studied the medical records of the 254 cases during pregnancy by retrospective analysis.Then we record age of pregnant women, height, weight, pregnant childbirth weight before, producing inferior generally, family history of diabetes, pregnancy, whether to use insulin pregnancy complication of pregnant women and complications, neonatal weight and born blood sugar, fasting blood glucose, dyslipidemia items, OGTT abnormal items, etc. By multivariate conditional Logistic regression analysis ,we want to find risk factors for GDM patients with long-term type 2 diabetes. Using repeat sequence analysis method to explore the relation between postpartum body mass index in different periods of GDM women and long-term DM pathogenesis. We use T test analysis to compare two groups to find whether there is any significant difference with pre-pregnancy and after pregnancy in age, pre-pregnancy BMI, pregnancy weight growth rate, differences in postpartum weight before pregnancy. 3) We researched on 254 subjects who were diagnosed by ADA and 60 cases who were not diagnosed by the latest standards but by ADA. Retrospective - prospective case control study was used.We explord the useness of IADPSG in China for clinical diagnosis of GDM.Results:(1) The incidence of GDM was 5.67% in hospital antenatal clinics and hospital delivery groups. With the visitor postpartum 42 days ~ 5 years oxpatiation review OGTT test, 44 patients were diagnosed of DM, 54 people of IGT in the 254 patients. We found that incidence of sugar metabolic abnormalities (namely OGTT abnormal rate) is 38.58%(80/254),and the incidence of sugar metabolism disorders are increased year trend.(2) Use pregnancy age, production times, DM family history, pregnant BMI, pregnancy weight growth, pregnancy postpartum weight difference, pregnancy fasting glucose, pregnancy use insulin, pregnancy OGTT abnormal item, dyslipidemia items as independent variables, Postpartum sugar metabolism disorders (OGTT abnormal) for variable gradually more factors should not conditional Logistic regression analysis, DM family history, pregnant, BMI, pregnant and postpartum weight difference, pregnancy fasting glucose, pregnancy use insulin and pregnancy OGTT anomalies of GDM pregnant women with postpartum increase are risk factors for abnormal glucose metabolism .(OR=9.222,95%CI:3.503~24.282;OR=1.176, 95%CI:1.014~1.364;OR=1.246, 95%CI:1.142~1.360;OR=1.740, 95%CI:1.185~2.556;OR=3.559, 95%CI:1.549~1.364;OR=3.069, 95%CI:1.520~6.179)。It is no significant for abnormal glucose metabolism in the prenatal and postnatal differences which in postpartum one,three and five years(P>0.05).(3) The analysis of incidence of a pregnant woman postpartum 42 days OGTT abnormal group and OGTT normal group in the future five years showed significant comparative differences between two groups of sugar metabolism abnormal (χ2=7.923,p=0.005).(4) People who were diagnosed with GDM by IADPSG standards but not by ADA diagnostic criteria is defined as A group. People who were diagnosed with ADA standards but not by GDM is defined as the B group.There are significance difference in age, body mass index (BMI) and pregnant during pregnancy weight growth rates, cesarean section rate between two groups (p<0.05). The difference was significant in the two groups of Macrosomia incidence and neonatal hypoglycemia (p < 0.05). The difference is significant in both groups of postpartum sugar metabolism abnormal rate (OGTT abnormal rate) with between meaning(χ2=11.98,p=0.001)。Conclusion:(1)The gestational diabetes patients with long-term development of type 2 diabetes, high risk for GDM pregnant women for postpartum follow-up. It is necessary to give a follow up to the GDM pregnant women postpartum .And it is very necessary to give a follow up to the GDM pregnant women postpartum after postpartum 42 days.(2)Risk factor for abnormal glucose metabolism are family history of diabetes , pre-pregnancy body mass index, body weight difference between pre-pregnancy and postpartum, pregnancy fasting blood glucose, insulin use during pregnancy situation and abnormal OGTT during pregnancy after the GDM pregnancy . The persistence of postpartum abnormal lipid metabolism may be the development of GDM women postpartum risk factors for the DM.(3)In the glucose tolerance test , the latest diagnostic criteria for GDM population is too low for our country and require unusual items times too small, easily diagnosised more patients with the clinical application of this new standard and is applicable to data of the crowd has yet to be further examined. It's necessary to increase the sample size to further study the application of the standard value in China.
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