·糖尿病临床流行病学·

　　【摘要】 目的 观察国际糖尿病妊娠研究组(IADPSG)新的诊断标准调查GDM的患病情况，并分析危险因素。 方法 采用调查问卷方法收集患者的一般资料，于24～28周行75 g OGTT，测定0 h、1 h、2 hPG。检测TC、TG等指标。采用Pearson相关分析和Logistic回归分析分析GDM的危险因素 结果 最终完成者690例，GDM患病率为33.3%(230/690)。GDM组年龄、孕前体重、孕前BMI、孕期体重增加(孕前体重-初次建卡时体重)、出生时体重、TG均高于NGT组(P<0.05)。随年龄、孕前BMI增加，GDM患病率增加，>35岁者的患病率是<25岁者的2.06倍。BMI>28 kg/m2者GDM患病率达71.43%(10/14)。GDM组多次妊娠和既往不良妊娠比例增高。Logistic回归分析显示，糖尿病家族史、剖宫产史、巨大儿生育史是GDM独立危险因素。 结论 新诊断标准使GDM患病率增加，宜针对GDM的危险因素实施防治，以降低GDM发病率。

　　【关键词】 妊娠期糖尿病;患病率;危险因素

　　【Abstract】 Objective To survey the prevalence of gestational diabetes mellitus with the diagnostic criteria of IADPSG, and analyze the risk factors of GDM. Methods The clinical characteristics of GDM were recorded by questionnaire survey. The oral glucose tolerance test was performed during 24~28 week of pregnancy in all 690 participants. The fasting blood glucose, one-hour and two-hour postprandial glucose were measured. Results A total of 690 participants were surveyed, GDM add up to 230, with the prevalence of GDM of 33.3%. Compared with NGT group, age, weight and BMI before pregnancy, weight gain (weight before pregnancy minus weight at the first documentation)during pregnancy, weight after birth, and TG level were higher inGDM group(P<0.05). The prevalence of GDM increased along with the increasing of age and BMI. The prevalence of GDM was 2.06 times in patients >35 years old versus patients <25 years old. The prevalence of GDM reached 71.43% (10/14) in BMI >28 kg/m2. The prevalence of multiple and adverse pregnancy were higher in GDM group. Logistic regression showed diabetes family history, the history of cesarean section, fetal macrosomia birth history are independent risk factors for GDM. Conclusion With the new diagnostic criteria, the prevalence of GDM is increased remarkably. Intervention of risk factors of GDM should be done in order to reduce the morbidity of GDM.

　　【Key words】 Gestational diabetes mellitus; Prevalence; Risk factors