| [Objective] To investigate the current status of gestational diabetes mellitus in xiamen city and explore the risk factors related to the onset of gestational diabetes mellitus,so as to provide theoretical basis for reducing the incidence of gestational diabetes mellitus and improving the prognosis of adverse pregnancy outcomes.[Research object and method]1.Research objects: retrospective investigation was conducted to obtain all the hospitalized pregnant women with the qualification of midwify-delivery in xiamen from July 2015 to December 2018 through the cloud platform of maternal and child health in xiamen.According to the diagnostic criteria of 75 g oral glucose tolerance test(75g OGTT): before and 1 and 2 hours after the administration of sugar,the three blood glucose values should be 5.1,10.0,8.5mmol/L(92,180,153mg/dl),respectively.Any blood glucose level that meets or exceeds the above criteria is diagnosed as gestational diabetes mellitus(GDM)[1],which is divided into gestational diabetes mellitus(GDM)group and non-gestational diabetes mellitus(non-gdm)group.2.The data of the pregnant women in the GDM group and the non-gdm group were obtained,including household registration,age,number of prenatal examinations,family history of diabetes,number of previous pregnancies,number of previous vaginal deliveries,number of previous cesarean sections,pre-pregnancy body mass index(BMI),added value of BMI during pregnancy,hemoglobin and blood type,etc.,and the data were compared and statistically analyzed.Pregnancy outcome indicators of the two groups of pregnant women were obtained,including gestational week,mode of delivery,macrosomia,average birth weight of newborn,and perinatal death.3.Descriptive analysis,chi-square test,t-test and multi-factor analysis were conducted with statistical software.Chi-square test was used for the comparison between the two groups of counting data,independent sample t test was used for measurement data,measurement data of normal distribution was expressed as mean standard deviation,and multivariate logistic regression analysis was used for data analysis,P<0.05 was statistically significant.[Results] 1.The analysis of pregnant women was limited to delivery after 28 weeks to reduce time bias.A total of 290021 pregnant women were included in the study,including 43553 in the second half of 2015,86547 in 2016,87034 in 2017 and 72887 in 2018.There were 41,631 patients diagnosed with GDM,including 4058 patients in the second half of 2015,12073 patients in 2016,16,674 patients in 2017 and 11,843 patients in 2018.The annual incidence of GDM was 9.21%,13.95%,15.69% and 16.25%,respectively,with an average incidence of 14.35%.The annual incidence difference was statistically significant.In summary,the morbidity of each season was 15.05% in spring,15.49% in summer,13.17% in autumn and 14.26% in winter.The highest morbidity was found in summer,and the difference was statistically significant.2.Statistical analysis was performed on data related to gestational diabetes,including household registration,age,number of labor tests,family history of diabetes,number of previous pregnancies,number of previous vaginal deliveries,number of previous cesarean sections,body mass index(BMI),hemoglobin and blood type before pregnancy,with statistically significant differences(P<0).05).Multivariate logistic regression showed that age,family history of diabetes,pre-pregnancy BMI and blood type were independent risk factors for GDM(all P <0.05).The mean gestational weeks in GDM group and non-gdm group was 38.94 1.45 weeks,and the mean gestational weeks in non-gdm group was 39.22 1.75 weeks.Among the delivery methods,there were 25750(62.33%)GDM vaginal delivery and 15560(37.67%)cesarean delivery.There were 167,862 patients(68.17%)with non-gdm natural labor,and 78,361 patients(31.83%)with natural labor.The difference between the two groups was statistically significant.The average weight of newborns in the GDM group was 3249.27 460.14 g,and the average weight of newborns in the non-gdm group was 3235.89 430.47 g.Neonatal body weight was divided into three groups: low body weight,normal body weight and macrosomia.After chi-square test,the difference of neonatal body weight composition between GDM group and non-gdm group was statistically significant(P<0.05),and the incidence of macrosomia in GDM group was significantly higher than that in non-gdm group.4.The total number of GDM neonates was 41,276,and the perinatal death rate was 95,with a mortality rate of 0.23%.The total number of non-gdm neonates was 249,126,and the perinatal death rate was 736,with a mortality rate of 0.29%.The gestational weeks of GDM perinatal death were the most at 34 and 39 weeks.[Conclusion] 1.The incidence of gestational diabetes increased year by year in xiamen,with the highest incidence in summer.2.Family history of diabetes,age,pre-pregnancy BMI and blood type were independent risk factors for GDM. |
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