搜索到20652篇“ GESTATIONAL“的相关文章
The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus
2024年
Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.
Atochi Prince WorukaCelestine Osita John
双胎妊娠孕妇孕期体重增加与不良围产结局的关系
2024年
目的探讨双胎妊娠孕妇孕期体重增加(gestational weight gain,GWG)与不良围产结局的关系。方法回顾性纳入2012年1月至2022年10月在北京大学人民医院孕周≥25周活产分娩的双胎妊娠孕妇及其子代为研究对象。孕期总GWG按照孕周进行标准化处理,并根据2009年美国医学研究所(Institute of Medicine,IOM)指南分为增重不足(GWG低于IOM指南推荐)、增重适宜(GWG在IOM指南推荐范围之内)和增重过多(GWG高于IOM指南推荐)3组。3组间一般资料及围产结局比较采用方差分析、Kruskal-Wallis检验及Bonferroni校正或χ^(2)分割法。采用多变量logistic回归模型和广义估计方程中的logistic回归模型分别分析GWG对母亲及新生儿不良结局的独立影响。结果本研究共纳入794例双胎妊娠孕妇及其1588例活产新生儿。增重适宜、增重不足和增重过多3组孕妇分别有360例(45.3%)、356例(44.8%)和78例(9.8%)。增重不足和增重过多均与早产的风险增加有关[校正OR值分别为1.39(95%CI:1.04~1.88)和1.70(95%CI:1.05~2.78)]。GWG增重不足与妊娠期糖尿病(校正OR=1.42,95%CI:1.00~2.01)、低出生体重儿(校正OR=2.04,95%CI:1.57~2.66)的风险增加有关;与子痫或子痫前期(校正OR=0.50,95%CI:0.33~0.75)、剖宫产(校正OR=0.48,95%CI:0.30~0.77)、双胎发育不一致(校正OR=0.56,95%CI:0.37~0.85)、大于胎龄儿(校正OR=0.46,95%CI:0.35~0.61)的风险降低有关。增重过多与子痫或子痫前期(校正OR=2.85,95%CI:1.65~4.91)、大于胎龄儿(校正OR=2.49,95%CI:1.60~3.86)风险增加有关,与低出生体重儿的风险降低有关(校正OR=0.42,95%CI:0.27~0.65)。结论半数以上双胎妊娠孕妇GWG不在指南推荐范围。GWG低于或高于IOM指南推荐均与不良围产结局有关,尤其与早产风险增加有关。
李洋洋刘捷侯林马紫君曾超美秦炯吴燕秋
关键词:双胎妊娠早产妊娠期高血压疾病妊娠期糖尿病
妊娠糖尿病患者合并妊娠高血压的风险预测模型构建
2024年
目的探讨妊娠糖尿病(GDM)患者合并妊娠高血压的危险因素,并建立列线图预测模型。方法将294例GDM患者按照2∶1比例分为建模组(196例)和验证组(98例)。根据是否合并妊娠高血压将建模组分为合并高血压组(51例)和未合并高血压组(145例)。分析GDM合并妊娠高血压的影响因素,构建列线图模型并验证。结果孕前超重/肥胖、孕期体质量增长过度、口服葡萄糖耐量试验3项异常、同型半胱氨酸(Hcy)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、胰岛素抵抗(HOMA-IR)、丙二醛(MDA)、合并焦虑/抑郁情绪均是GDM合并妊娠高血压的影响因素(OR=2.776、2.149、5.008、4.586、4.208、4.047、3.473、0.503、3.688、3.317、2.305,P<0.05)。将上述影响因素作为预测指标,构建GDM合并妊娠高血压风险预测列线图模型,建模组和验证组一致性指数分别为0.830、0.827,校准曲线和理想曲线拟合度均较好。受试者工作特征曲线评估模型显示,建模组、验证组曲线下面积分别为0.859、0.850;决策曲线显示,建模组、验证组在风险阈值概率分别为0.02~0.89、0.02~0.85时可获得较高的净获益值。结论孕前超重/肥胖、孕期体质量增长过度、口服葡萄糖耐量试验3项异常、Hcy、TG、TC、LDL、HDL、HOMA-IR、MDA、合并焦虑/抑郁情绪均是GDM合并妊娠高血压的影响因素,据此构建的列线图模型预测效能较好,可指导临床筛选高风险人群。
张年芳魏翠赵雪飘
关键词:妊娠糖尿病妊娠高血压列线图
妊娠期糖尿病患者体重增长情况及与母婴不良结局的相关性研究
2024年
目的根据我国妊娠期体重增长(GWG)标准,分析妊娠期糖尿病(GDM)孕妇妊娠期体重增长情况及其和母婴不良结局的相关性。方法选取北京市朝阳区2019年2月至2022年8月建档分娩的单胎妊娠GDM孕妇10539例为研究对象,采用Logistic回归分析GDM孕妇GWG与妊娠期高血压、妊娠合并贫血、子痫前期/子痫、胎膜早破、剖宫产、低出生体重、巨大儿、小于胎龄儿(SGA)、大于胎龄儿(LGA)的相关性。结果10539例GDM孕妇中,35.53%GWG过多,20.56%GWG不足,43.90%GWG适宜;42.49%的超重人群和45.61%的肥胖人群GWG过多。在调整年龄、民族、文化程度、职业、孕次、孕前体质量指数、孕龄后,多因素Logistic回归分析结果显示,GWG过多是妊娠期高血压、子痫前期/子痫、剖宫产、巨大儿和LGA的危险因素(aOR值介于1.39~2.37之间,P<0.05),是低出生体重、SGA的保护性因素(aOR值分别为0.60、0.61,P<0.01);而GWG不足是低出生体重、SGA的危险因素(aOR值分别为1.81、1.38,P<0.01),是胎膜早破、剖宫产、LGA的保护性因素(aOR值分别为0.65、0.89、0.81,P<0.05);未观察到GWG与妊娠合并贫血的相关性(P>0.05)。结论在我国妊娠期体重增长标准下,GDM孕妇中约20%增重不足,约40%的肥胖和超重人群增重过多。GDM孕妇妊娠期体重增长过多和不足均会增加母婴不良结局的风险,为GDM人群制定针对性妊娠期增重标准,指导和监测GDM孕妇妊娠期增重具有一定的意义。
沈蕊郑睿敏王立聪陈小劲张彤
关键词:妊娠期糖尿病妊娠
妊娠体重增加对妊娠期糖尿病的肥胖患者妊娠结局及新生儿结局的影响
2024年
目的比较不同程度妊娠期体重增加(GWG)对孕产妇和新生儿结局的影响。方法收集2020年12月-2022年12月安徽医科大学附属安庆医院产科分娩的患有妊娠糖尿病的肥胖产妇324例临床资料,根据妊娠期体重增加情况分为GWG不足组(n=110),GWG适当组(n=108),GWG过量组(n=106),比较三组妊娠结局及新生儿结局。结果与GWG适当组和GWG过量组比较,GWG不足组妊娠期高血压、子痫前期、剖宫产发生率、孕晚期HbA1c均较低,BMI、产后血糖恢复至正常的比例较高,差异有统计学意义(P<0.05)。GWG不足组新生儿出生体重及巨大儿、LGA的发生率低于GWG适量和GWG过量组(P<0.05)。Logistic多因素回归分析显示,GWG不足组LGA、子痫前期、需要剖宫产、患糖尿病的风险明显降低。GWG过量组LGA、剖宫产的风险明显增加。结论妊娠期体重增加过量GDM肥胖妇女不良结局发生率更高,体重增加不足的更有利于得到良好的妊娠结局及新生儿结局。
程敏李青陈彬
关键词:妊娠期糖尿病肥胖
Developing and validating a predictive model of delivering large-forgestational-age infants among women with gestational diabetes mellitus
2024年
BACKGROUND The birth of large-for-gestational-age(LGA)infants is associated with many shortterm adverse pregnancy outcomes.It has been observed that the proportion of LGA infants born to pregnant women with gestational diabetes mellitus(GDM)is significantly higher than that born to healthy pregnant women.However,traditional methods for the diagnosis of LGA have limitations.Therefore,this study aims to establish a predictive model that can effectively identify women with GDM who are at risk of delivering LGA infants.AIM To develop and validate a nomogram prediction model of delivering LGA infants among pregnant women with GDM,and provide strategies for the effective prevention and timely intervention of LGA.METHODS The multivariable prediction model was developed by carrying out the following steps.First,the variables that were associated with LGA risk in pregnant women with GDM were screened by univariate analyses,for which the P value was<0.10.Subsequently,Least Absolute Shrinkage and Selection Operator regression was fit using ten cross-validations,and the optimal combination factors were se-lected by choosing lambda 1se as the criterion.The final predictors were deter-mined by multiple backward stepwise logistic regression analysis,in which only the independent variables were associated with LGA risk,with a P value<0.05.Finally,a risk prediction model was established and subsequently evaluated by using area under the receiver operating characteristic curve,calibration curve and decision curve analyses.RESULTS After using a multistep screening method,we establish a predictive model.Several risk factors for delivering an LGA infant were identified(P<0.01),including weight gain during pregnancy,parity,triglyceride-glucose index,free tetraiodothyronine level,abdominal circumference,alanine transaminase-aspartate aminotransferase ratio and weight at 24 gestational weeks.The nomogram’s prediction ability was supported by the area under the curve(0.703,0.709,and 0.699 for the training cohort,validation cohort,and t
Yi-Tian ZhuLan-Lan XiangYa-Jun ChenTian-Ying ZhongJun-Jun WangYu Zeng
关键词:NOMOGRAM
妊娠期糖尿病患者妊娠早期TyG指数与分娩小于胎龄儿的相关性
2024年
目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者妊娠早期甘油三酯葡萄糖指数(the triglyceride-gluscose index,TyG指数)与分娩小于胎龄儿(small for gestational age infant,SGA)之间的关系。方法选取2018年1月至2023年6月复旦大学附属上海市第五人民医院和新疆喀什地区第二人民医院产科孕早期建档并符合纳入标准的孕妇1532例为研究对象,根据孕妇24~28周行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果,将其分为GDM组(754例)及非GDM组(778例)。GDM组患者根据新生儿体重,将其分为SGA组、大于胎龄儿(large for gestational age infant,LGA)组和适于胎龄儿(appropriate for gestational age infant,AGA)组。分析GDM患者分娩SGA的独立影响因素,采用Logistic回归模型分析TyG指数与发生SGA的相关性。绘制ROC曲线以分析妊娠早期TyG指数对GDM患者分娩SGA的预测价值。结果GDM患者SGA组TyG指数显著低于LGA组、AGA组及非GDM组(P<0.05);多因素Logistic回归分析结果显示,TyG指数与GDM患者分娩SGA的发生独立相关(P<0.05);ROC曲线结果显示,妊娠早期TyG指数对GDM患者分娩SGA具有较好的预测价值(AUC=0.821,95%CI:0.763~0.879,P<0.001)。结论GDM患者妊娠早期TyG指数与分娩SGA之间存在独立相关,对于GDM患者分娩SGA具有较好的预测价值。
努尔比亚·西里甫李章燕臧淑妃古力斯坦·艾斯卡尔张瑞李悦徐鑫铭刘军
关键词:妊娠早期
孕期增长体质量、脂代谢指标与妊娠糖尿病患者不良妊娠结局的关系
2024年
目的探讨孕期增长体质量、脂代谢指标与妊娠糖尿病(GDM)患者不良妊娠结局的关系。方法选取2020年1月至2022年12月该院收治的120例GDM患者作为观察组,另选取同期在本院体检的健康孕妇795例作为对照组,再按照妊娠结局将GDM患者分为正常妊娠结局组及不良妊娠结局组。比较观察组和对照组孕期增长体质量、孕早、晚期脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、不良妊娠结局发生情况。比较不良妊娠结局组与正常妊娠结局组孕前体质量指数(BMI)、孕期增长体质量情况、孕早、晚期脂代谢指标。采用多因素Logistic回归分析GDM患者发生不良妊娠结局的危险因素。结果观察组孕期增长体质量高于对照组(P<0.05)。观察组孕晚期的TG、TC、LDL-C水平高于正常妊娠结局组,HDL-C水平低于正常妊娠结局组,差异均有统计学意义(P<0.05)。观察组不良妊娠结局总发生率高于对照组(P<0.05)。不良妊娠结局组有37例患者,正常妊娠结局组有83例患者。不良妊娠结局组与正常妊娠结局组孕前BMI和孕期增长体质量过少的患者比例比较,差异均无统计学意义(P>0.05)。不良妊娠结局组孕期增长体质量适宜的患者比例低于正常妊娠结局组,孕期增长体质量过多的患者比例高于正常妊娠结局组,差异均有统计学意义(P<0.05)。不良妊娠结局组孕晚期的TG、TC、LDL-C水平高于正常妊娠结局组,HDL-C水平低于正常妊娠结局组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,孕期增长体质量过多及孕晚期TG≥3.64 mmol/L、TC≥7.95 mmol/L、HDL-C≤1.65 mmol/L、LDL-C≥5.17 mmol/L是GDM患者发生不良妊娠结局的独立危险因素(P<0.05)。结论GDM患者存在孕期增长体质量过多现象,孕期增长体质量过多及孕晚期TG≥3.64 mmol/L、TC≥7.95 mmol/L、HDL-C≤1.65 mmol/L、LDL-C≥5.1
叶青燕吴凯练华珍
关键词:妊娠糖尿病
Analysis of Gestational Diabetes Mellitus (GDM) and Its Impact on Maternal and Fetal Health: A Comprehensive Dataset Study Using Data Analytic Tool Power BI
2024年
Gestational Diabetes Mellitus (GDM) is a significant health concern affecting pregnant women worldwide. It is characterized by elevated blood sugar levels during pregnancy and poses risks to both maternal and fetal health. Maternal complications of GDM include an increased risk of developing type 2 diabetes later in life, as well as hypertension and preeclampsia during pregnancy. Fetal complications may include macrosomia (large birth weight), birth injuries, and an increased risk of developing metabolic disorders later in life. Understanding the demographics, risk factors, and biomarkers associated with GDM is crucial for effective management and prevention strategies. This research aims to address these aspects comprehensively through the analysis of a dataset comprising 600 pregnant women. By exploring the demographics of the dataset and employing data modeling techniques, the study seeks to identify key risk factors associated with GDM. Moreover, by analyzing various biomarkers, the research aims to gain insights into the physiological mechanisms underlying GDM and its implications for maternal and fetal health. The significance of this research lies in its potential to inform clinical practice and public health policies related to GDM. By identifying demographic patterns and risk factors, healthcare providers can better tailor screening and intervention strategies for pregnant women at risk of GDM. Additionally, insights into biomarkers associated with GDM may contribute to the development of novel diagnostic tools and therapeutic approaches. Ultimately, by enhancing our understanding of GDM, this research aims to improve maternal and fetal outcomes and reduce the burden of this condition on healthcare systems and society. However, it’s important to acknowledge the limitations of the dataset used in this study. Further research utilizing larger and more diverse datasets, perhaps employing advanced data analysis techniques such as Power BI, is warranted to corroborate and expand upon the findings of this re
Shahistha Jabeen HashimArthur McAdams
关键词:PREGNANCY
适于胎龄与小于胎龄的极低出生体重儿身长增长对PICC尖端移位的影响及比较
2024年
目的探讨极低出生体重儿(very low birth weight,VLBW)中适于胎龄儿(appropriate for gestational age,AGA)和小于胎龄儿(small for gestational age,SGA)身长增长对经外周中心静脉置管(peripherally inserted central catheter,PICC)尖端移位的影响,并横向比较影响程度,帮助医护人员更好地把握导管尖端位置监测的时机。方法回顾性分析2021年1月—2022年6月在医院NICU住院并使用PICC的VLBW,按出生体质量和胎龄关系分为AGA组45例和SGA组19例,记录首次置管当日身长(Ht_(1))以及PICC尖端位置、置管期间胸片检查当日身长(Ht_(n))以及PICC尖端位置,并计算相应的身长增长率。身长增长率与PICC尖端移位的相关性用Spearman秩相关分析。将AGA和SGA的身长增长率分别与PICC尖端移位进行简单线性回归分析,构建回归模型,用协方差分析比较两组回归直线。结果VLBW中AGA组97.8%患儿出现移位,SGA组所有的患儿都出现移位,占比最多的均为移位3个椎体。Spearman秩相关分析结果显示,两组患儿身长增长率与PICC尖端移位均具有相关性(AGA组rs=-0.719,P<0.001;SGA组rs=-0.769,P<0.001),随着VLBW身长增长,PICC尖端逐渐移位远离心脏。简单线性回归分析结果显示,AGA组回归模型(R^(2)=0.517,调整后R^(2)=0.513,F=129.487,P<0.001),SGA组回归模型(R^(2)=0.591,调整后R^(2)=0.585,F=95.385,P<0.001)。协方差分析结果显示,由于回归系数检验没有统计学意义,两条直线平行,说明身长增长率对两组患儿位移的影响一致。截距比较有统计学意义(F=9.265,P=0.003),说明两组患儿位移的起点不同(即增长率为零时的位移位置),说明位移与是否为AGA、SGA有关。结论随着VLBW中AGA和SGA身长增长,PICC尖端逐渐移位远离心脏,但相同的身长增长率,SGA引起的导管尖端移位幅度更大。建议AGA身长增长率12.4%、SGA身长增长率9.5%可作为监测导管尖端位置的重要时机,以免导管尖端进一步移位至非中心静脉,
黄美霞林云云苏平庄春玲李玉萍
关键词:极低出生体重儿适于胎龄儿小于胎龄儿经外周中心静脉置管

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杨慧霞
作品数:1,114被引量:12,924H指数:58
供职机构:北京大学第一医院
研究主题:妊娠期糖尿病 妊娠期 妊娠合并糖尿病 妊娠 糖尿病
李晔
作品数:55被引量:49H指数:3
供职机构:北京大学第一医院
研究主题:GESTATIONAL 妇产科医师 队列研究 围产 子痫前期
李晔
作品数:16被引量:29H指数:2
供职机构:《中华围产医学杂志》编辑部
研究主题:妇产科医师 GESTATIONAL GDM 生活方式干预 妊娠期糖尿病
范玲
作品数:189被引量:2,739H指数:30
供职机构:首都医科大学附属北京妇产医院
研究主题:妊娠期糖尿病 妊娠期 产程 产后出血 孕妇
张眉花
作品数:48被引量:364H指数:10
供职机构:太原市妇幼保健院
研究主题:妊娠期糖尿病 糖代谢异常 妊娠期 妊娠 妊娠合并