中国全科医学 ›› 2023, Vol. 26 ›› Issue (26): 3320-3324.DOI: 10.12114/j.issn.1007-9572.2023.0125

• 论著 • 上一篇    下一篇

2014—2021年河北省妊娠期糖尿病患病率及流行病学研究

田美玲1,*(), 马国娟1, 杜立燕2, 肖远革1, 张赛1, 张翠1, 唐增军1   

  1. 1.050051 河北省石家庄市,河北省人民医院妇产科
    2.050000 河北省石家庄市,河北省妇幼保健中心信息管理科
  • 收稿日期:2022-12-20 修回日期:2022-03-26 出版日期:2023-09-15 发布日期:2023-04-26
  • 通讯作者: 田美玲

  • 作者贡献:田美玲负责文章设计、统计数据以及撰写论文,对文章整体负责;田美玲、马国娟分析与解释结果;杜立燕、肖远革、张赛、张翠收集与整理数据;唐增军对论文进行修订。
  • 基金资助:
    河北省卫生健康委青年科技课题(20230305,20200001)

Prevalence and Epidemiology of Gestational Diabetes Mellitus from 2014 to 2021 in Hebei Province

TIAN Meiling1,*(), MA Guojuan1, DU Liyan2, XIAO Yuange1, ZHANG Sai1, ZHANG Cui1, TANG Zengjun1   

  1. 1. Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang 050051, China
    2. Department of Information Management, Hebei Center for Maternal and Child Health, Shijiazhuang 050050, China
  • Received:2022-12-20 Revised:2022-03-26 Published:2023-09-15 Online:2023-04-26
  • Contact: TIAN Meiling

摘要: 背景 妊娠期糖尿病(GDM)是常见的妊娠并发症之一,GDM不仅增加了母体子痫前期、2型糖尿病等近远期并发症,同时也增加了胎儿畸形、巨大儿等风险的发生率,已成为不可忽视的公共卫生和社会问题。 目的 探讨河北省孕妇妊娠期糖尿病患病率和流行病学特征。 方法 采用横断面研究方法,收集2014—2021年河北省妇幼保健中心提供的来自孕产妇监测信息系统(22家监测医院)中的住院分娩信息,收集资料包括孕妇分娩医院、年龄、婚姻状况、受教育程度、妊娠次数、产次、产检次数、分娩季节、本次妊娠期并发症以及分娩方式、新生儿性别、体质量及是否入住NICU等资料。 结果 本研究共入选366 212例孕妇,其中确诊GDM者25 995例,患病率为7.1%。2014—2021年河北省孕妇GDM患病率呈逐年增长趋势(χ2趋势=6 921.4,P<0.001);高龄孕妇GDM患病率呈逐年增长趋势(χ2趋势=779.0,P<0.001);城市孕妇GDM患病率呈逐年增长趋势(χ2趋势=5 057.1,P<0.001)。河北省不同地区GDM患病率比较,差异有统计学意义(χ2=16 919.785,P<0.001)。2014—2021年河北省城市孕妇GDM患病率为10.6%(19 200/180 369),高于农村孕妇的3.7%(6 795/185 843)(χ2=6 779.019,P<0.001)。2014—2021年河北省一级医院孕妇GDM患病率为0.7%(34/4 731),二级医院孕妇GDM患病率为3.7%(6 733/180 923),三级医院孕妇GDM患病率为10.6%(19 228/180 558),不同等级医院孕妇GDM患病率比较,差异有统计学意义(χ2=6 872.800,P<0.001)。不同年龄、受教育程度、妊娠次数、产次、产检次数者GDM患病率比较,差异均有统计学意义(P<0.05);其中18~<35、35~<40、≥40岁孕妇GDM患病率均高于<18岁孕妇(P<0.05),35~<40、≥40岁孕妇GDM患病率均高于18~<35岁孕妇(P<0.05);大学及以上学历孕妇GDM患病率均高于高中及初中、小学及以下孕妇(P<0.05);妊娠次数≥2次的孕妇GDM患病率高于1次妊娠者;经产妇GDM患病率高于初产妇(P<0.05);产检次数≥8次孕妇GDM患病率高于产检次数<8次的孕妇(P<0.05)。2014—2021年河北省分娩于春季(3~5月)的孕妇GDM患病率为7.27%(6 583/90 546),夏季(6~8月)为6.95%(6 360/91 521),秋季(9~11月)为7.08%(6 632/93 729),冬季(12~次年2月)为7.10%(6 420/90 416),不同季节的孕妇GDM患病率比较,差异有统计学意义(χ2=9.350,P<0.05)。不同妊娠期高血压疾病、贫血、宫缩乏力、分娩方式、巨大儿的孕妇GDM患病率比较,差异均有统计学意义(P<0.05)。 结论 2014—2021年河北省孕妇GDM患病率为7.1%,且GDM患病率呈逐年增长趋势。高龄、城市、高学历、多次妊娠、经产妇GDM患病率增加。

关键词: 糖尿病,妊娠, 河北省, 患病率, 流行病学, 公共卫生

Abstract:

Background

Gestational diabetes mellitus (GDM) is one of the common pregnancy complications, which not only increases the maternal risk of short-term and long-term complications such as maternal preeclampsia and type 2 diabetes, but also the incidence rates of fetal malformation, macrosomia, etc. GDM has become a public health and social issue which can not be ignored.

Objective

To investigate the prevalence and epidemiological characteristics of GDM in Hebei Province.

Methods

Using a cross-sectional study method, the relevant data of inpatient deliveries from maternal monitoring information system involving 22 monitoring hospitals provided by Hebei Center for Maternal and Child Health were collected, including maternal delivery hospital, maternal age, marital status, education level, number of pregnancies, deliveries and prenatal examinations, season of delivery, complications during this pregnancy, mode of delivery, gender and body mass of newborn, and occupancy at NICU.

Results

A total of 366 212 pregnant women were enrolled in this study, 25 995 of whom were diagnosed with GDM, with the incidence rate of 7.1%. The prevalence of maternal GDM showed an upward trend year after year from 2014 to 2021 (χ2trend=6 921.4, P<0.001). The incidence rate of GDM in advanced maternal aged (χ2trend=779.0, P<0.001) and urban maternity (χ2trend=5 057.1, P<0.001), showing an upward trend year after year. And there were statistical significant differences in the prevalence of GDM among different regions of Hebei Province (χ2=16 919.785, P<0.001). The prevalence of maternal GDM in urban〔10.6% (19 200/180 369) 〕was higher than rural〔3.7% (6 795/185 843) 〕 from 2014 to 2021 in Hebei Province (χ2=6 872.800, P<0.001). There were significant differences in prevalence of maternal GDM among primary〔0.7% (34/4 731) 〕, secondary〔3.7% (6 733/180 923) 〕, and tertiary hospitals〔10.6% (19 228/180 558) 〕from 2014 to 2021 in Hebei Province (χ2=6 872.800, P<0.001). There were statistically significant differences in the prevalence of maternal GDM among women of different maternal age, educational level, number of pregnancies, deliveries and prenatal examinations (P<0.05); The prevalence of GDM in women aged 18-<35, 35-<40, and ≥40 years was higher than women aged <18 years, and the prevalence of GDM in women aged 35-<40, and ≥40 years was higher than women aged 18-<35 years; The prevalence of GDM of women with university or higher education level was higher than women with high school, junior high school, primary school and illiteracy; The prevalence of GDM of women with multiple pregnancies was higher than women with 1 pregnancy; The prevalence of GDM of multipara was higher than unipara; The prevalence of GDM of women ≥8 prenatal examinations was higher than women of <8 prenatal examinations. There were statistically significant differences in the prevalence of maternal GDM among women with deliver season of spring (March to May) 〔7.27% (6 583/90 546) 〕, summer (June to August) 〔6.95% (6 360/91 521) 〕, autumn (September to November) 〔7.08% (6 632/93 729) 〕 and winter (December to February) 〔7.10% (6 420/90 416) 〕 from 2014 to 2021 in Hebei Province (χ2=9.350, P<0.05). The differences in maternal GDM were statistically significant when comparing the combination of gestational hypertension, anemia and uterine atony, delivery modes, and deliver of macrosomia (P<0.05) .

Conclusion

The prevalence of GDM in Hebei Province was 7.1% from 2014 to 2021, showing an upward trend from 2014-2021. And the prevalence of GDM is increased in women with advanced age, living in urban, with high education level, multiple pregnancies, and multipara.

Key words: Diabetes, gestational, Hebei Province, Prevalence, Epidemiology, Public health