| Objective:To explore the incidence of gestational diabetes mellitus(GDM)and adverse birth outcomes in late pregnancy in two hospitals of Shenyang,and to clarify its influencing factors,so as to provide theoretical basis for reducing the incidence of GDM and adverse birth outcomes.Methods:The study population came from the maternal-child-adolescent cohort of the National Key R&D Program of China-“China Northeast Cohort Study”.According to the inclusion and exclusion criteria,402 pregnant women were included and divided into GDM group and non-GDM group according to the fasting blood glucose of pregnant women at 28-36 weeks.The health information of pregnant women was obtained by biochemical test and questionnaire survey,and the neonatal birth situation was recorded from the follow-up to the end of delivery.108 pregnant women were given a 3-day24-hour dietary review to obtain the dietary nutrient intake of pregnant women.SPSS26.0 software was used for statistical description and analysis.Results: 1、The detection rate of GDM was 7.96%.The average birth weight of newborns was 3352.52±505.90 g,the incidence of low birth weight was 4.73%,the incidence of macrosomia was 10.94%,the incidence of premature birth was 4.48%,and cesarean section rate was 45.02%.2、Through dietary survey,the actual intakes of energy,calcium,iron,zinc,vitamin A,vitamin C and niacin in late pregnancy were 1553.12±350.90 kcal/d 、 261.61±101.65mg/d、13.56 ± 5.51mg/d、6.06 ± 2.67mg/d、10.06 ± 3.90mg/d、376.67 ± 244.36 ug RAE/d、75.08 ± 36 mg/d,which were lower than recommended nutrient intake(RNI).The actual intake of vitamin E was 17.98%±24 mga-TE/d,higher than adequate intakes(AI).3、There was a positive correlation between the average intake of energy,protein,vitamin A and niacin in the diet of late pregnancy and fasting blood glucose level(P<0.05),the correlation coefficients were 0.20,0.23,0.20 and 0.20 respectively.The intake of niacin in late pregnancy diet was positively correlated with neonatal birth weight(P<0.05),the Spearman correlation coefficien was 0.21.4、Compared with non GDM pregnant women,the average daily intakes of energy,protein,iron and zinc in GDM pregnant women were higher than those in non GDM group,and the difference was statistically significant(P<0.05).The neonatal birth weight of GDM pregnant women was 3558.75±511.28 g,which was higher than that of non GDM group(P<0.05).The Hemoglobin level of GDM pregnant women was 117.61±11.47g/L,which was lower than that of non GDM pregnant women(P<0.05).The Hemoglobin level was significantly associated with GDM(P<0.05).After adjusting for factors,the OR value of the fourth percentile was 0.16(95% CI: 0.03～0.80).5、The level of Serum Ferritin in late pregnancy was statistically correlated with the occurrence of cesarean section(P<0.05),and the OR value in the fourth quartile was 0.49(95% CI: 0.26～0.93).Conclusion: 1、In this study,the detection rate of GDM in two hospitals of Shenyang was 7.96%.The incidence of low birth weight,macrosomia,premature delivery and cesarean section was 4.73%,10.94%,4.48% and 45.02%,respectively.2、Through dietary survey,the actual intakes of energy,calcium,iron,zinc,vitamin A,vitamin C and niacin in late pregnancy were lower than those in RNI,and the actual intakes of vitamin E were higher than those in AI.There was a positive correlation between the average intake of energy,protein,vitamin A and niacin in the diet of late pregnancy and fasting blood glucose level.There was a positive correlation between the intake of nicotinic acid and the birth weight of the newborn.3、The level of Hemoglobin was related to the occurrence of GDM and was an independent factor.4、Serum Ferritin level in late pregnancy was associated with the occurrence of cesarean section and was an independent factor. |
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