A Clinical Analysis Of Risk Factors Of Gestational Diabetes Mellitus And Effects On Mother-infant Prognosis

BackgroundDiabetes mellitus(DM) has become a global public health problem,and its morbidity increases dramatically,especially in some developing countries.According to the statistics of International Diabetes Federation(IDF),China has the most adult diabetics,surpassing the number of India.Gestational Diabetes Mellitus(GDM) is an independent type of diabetes,with the morbidity increasing steadily in recent years.Without any control of blood glucose during pregnancy,GDM will endanger mothers and infants.Improving researches on GDM complications, techniques of diagnosis and complications treatment,and the cooperation of departments(Endocrinology, Obstetrics and Neonatology) decrease the rate of the morbidity and deformity of infants.However,GDM is a complicated process within which there are many complications having a long-lasting influence on mothers and infants, probably a serious spiritual and financial burden both on the individual and the society.Therefore,to explore the risk factors associated with the onset of GDM, to take timely and effective prevention and control measures is the important research direction.Objective1.To evaluate the prevalence of GDM among patients in the obstetric department.2.To analyze the risk factors for GDM.3.To investigate effects of GDM on perinatal and long-lasting influence on mothers and infants.MethodThis research is based on the retrospective clinical investigation with the 1281 samples selected among the GDM patients admitted by Obstetric department of People’s Liberation Army No. 202 hospital from Nov.1st,2013 to Oct.31 st,2014 and 1281 health samples of the same source as the control group.Research statistics are classified as age,gravidity,parity,pre-pregnancy Body Mass Index(BMI),weight gain,family history of diabetes,history of abnormal gestation, Hbs Ag(+), history of macrosomia, history of GDM,gestational age, way of delivery, oligohydramnios, polyhydramnios, amniotic fluid contamination,hypertensive disorders in pregnancy(HDP),premature rupture of membranes,fetal distress, premature delivery,stillbirth,neonatal hypoglycemia,and macrosomia. The indicators above were anallgsed by SPSS20.0 sofe were and all the factors are analyzed with Logistic regression analysis with T-test of quantitative assessment on the pregnancy outcome and with chi-square test of qualitative data.Results1.Morbidity of GDM was 17.1% among patients in the obstetric department.(false negative rate 82.2%).2.According to the analysis of 10 factors:There were in parity, weight gain, history of abnormal gestation,Hbs Ag(+),history of macrosomia,history of GDM no statistical significance between the 2 groups(P>0.05).There were in Age,gravidity,re-pregnancy Body Mass Index(BMI), family history of diabetes statistical significance between the 2groups(P<0.05).After multivariate non-conditioned logistic regression analysis of these 4factors,it can be concluded that there are 3 risk factors of GDM,with the most dangerous factor,pre-pregnancy Body Mass Index(BMI)(OR=2.628,P<0.05),followed by family history of diabetes(OR=2.146, P<0.05) and age of the mother(OR=1.433, P<0.05).3. There were 1281 samples of GDM in the research with a gestational age of(38.57±1.46)weeks,while the 1281 randomly selected healthy women had a gestational age of(38.92±1.2)weeks.Comparison of gestational age shows statistical significance(P<0.05).The gestational age of GDM is shorter than that in the control group.There were169 cases of polyhydramnios,140 cases of hypertensive disorders in pregnancy,186 cases of fetal distress,and 252 cases of macrosomia in the GDM group,morbidity statistical higher than the control group(P<0. 05). Cesarean section, oligohydramnios, amniotic fluid contamination,premature rupture of membranes,preterm delivery,stillbirth,and neonatal hypoglycemia,showed no significant differences between the GDM group and control group(P>0.05).Conclusion1.Morbidity of GDM was 17.1% among patients in the obstetric department.(false negative rate 82.2%).2.Pre-pregnancy BMI,family history of diabetes and age are risk factors of GDM.3. GDM endangers mothers and infants, such as the shortened gestation age and increased morbidity of the polyhydramnios, hypertensive disorders in pregnancy, fetal distress,and macrosomia.