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妊娠期糖尿病发病影响因素的Meta分析
作者:阿吉古丽· 阿布力米提  帕它木· 莫合买提 
单位:新疆医科大学公共卫生学院 劳动卫生与环境卫生学教研室, 新疆 乌鲁木齐 830011
关键词:妊娠期糖尿病 影响因素 Meta分析 
分类号:R714.256
出版年·卷·期(页码):2020·39·第四期(452-462)
摘要:

目的:系统评价妊娠期糖尿病(GDM)发病的影响因素,为减少GDM的发生提供科学依据。方法:通过系统检索中国知网、中国生物医学文献数据库、维普期刊库、万方、PubMed、考克兰等数据库,收集2013至2018年公开发表的关于女性GDM影响因素的病例对照研究,按照NOS量表标准对纳入文献进行质量评价,采用RevMan5.3软件对纳入的文献进行Meta分析。结果:最终纳入35篇文献,研究对象共106 539例。经Meta分析差异有统计学意义的因素为糖尿病家族史(OR=2.95,95% CI 2.06~4.24)、年龄≥35岁(OR=2.66,95% CI 1.93~3.66)、孕次>1次(OR=1.74,95% CI 1.03~2.91)、不良孕产史(OR=2.14,95% CI 1.48~3.08)、高血压史(OR=3.19,95% CI 1.91~5.32)、体重指数(BMI)≥24 kg·m-2OR=3.47,95% CI 2.65~4.55)、体育运动(OR=0.28,95% CI 0.13~0.61)、被动吸烟(OR=1.32,95% CI 1.17~1.49)、喜爱甜食(OR=3.34,95% CI 2.67~4.17)。结论:影响GDM发生的因素有糖尿病家族史、年龄、孕次>1次、不良孕产史、高血压史、BMI≥24 kg·m-2、被动吸烟、喜爱甜食,保护因素为体育锻炼。在孕前保健工作中应对育龄妇女开展饮食管理,使其控制体重;对妊娠妇女还应加强产前保健,避免被动吸烟,指导其适当运动。

Objective: To systematically evaluate the influencing factors and intervention measures of gestational diabetes mellitus (GDM),to provide scientific proof on reducing the incidence of GDM. Methods: The case-control trials of influencing factors of female GDM published from 2013 to 2018 were collected by systematically searching the databases of Chinese Biomedicine, Weipu Journal Library, Wanfang,PubMed, Corkland, etc. The quality of the included literature was evaluated according to the standard of NOS scale. Meta analysis of the included literature was carried out by RevMan5.3 software. Results: A total of 106 539 subjects were included in 35 articles. The significant factors of OR value and 95% CI calculated by Meta analysis were as follows:family history of diabetes (OR=2.95,95% CI 2.06-4.24), age ≥ 35 years old (OR=2.66,95% CI 1.93-3.66), pregnant times>1(OR=1.74,95% CI 1.03-2.91), abnormal pregnancy history (OR=2.14,95% CI 1.48-3.08), hypertension history (OR=3.19,95% CI 1.91-5.32), BMI ≥ 24 kg·m-2 (OR=3.47,95% CI 2.65-4.55), sports (OR=0.28,95% CI 0.13-0.61), passive smoking (OR=1.32,95% CI 1.17-1.49), sweets(OR=3.34,95% CI 2.67-4.17). Conclusion: The main influence factors of GDM are family history of diabetes,age,pregnant times>1, abnormal pregnancy and delivery history, hypertension history, BMI ≥ 24 kg·m-2, passive smoking, sweets, and the protective factor is physical exercise. In the course of health care, diet management and weight control should be carried out for women of childbearing age before pregnancy. In addition, antenatal care should be strengthened,passive smoking should be avoided, and appropriate sports should be taken.

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