摘要目的:分析妊娠期血糖异常患者产后6~12周糖代谢转归情况及其影响因素。方法:本研究为横断面研究，连续选取2019年12月1日至2020年12月31日于首都医科大学大兴教学医院妇产科建档并分娩的192例妊娠期血糖异常患者为研究对象，于产后6~12周完成75 g口服葡萄糖耐量试验，根据产后血糖情况分为产后血糖正常组（148例）和异常组（44例），采用假设检验比较两组妊娠前、妊娠期及产后相关临床资料，采用多因素logistic回归分析妊娠期血糖异常患者产后血糖异常的影响因素。结果:192例妊娠期血糖异常患者中，产后血糖异常发生率为22.92%（44/192），其中糖尿病6例（13.64%），糖耐量异常38例（86.36%）。异常组颈围、腰围、经产妇及妊娠期使用胰岛素比例均显著高于正常组［34.25（33.00，36.00）比33.55（32.00，35.00）cm、87.00（82.00，93.00）比84.00（78.00，90.00）cm、54.55%比37.16%、18.18%比6.76%］（均 P<0.05）。颈围大（ OR=1.315，95% CI：1.026~1.685）、经产妇（ OR=2.261，95% CI：1.057~4.836）、妊娠期使用胰岛素（ OR=3.767，95% CI：1.236~11.478）是产后血糖异常发生的正相关因素（均 P<0.05）。 结论:妊娠期血糖异常患者产后6~12周血糖异常发生率较高，颈围、产次、妊娠期使用胰岛素是产后血糖异常的重要影响因素。

abstractsObjective:To analyze the prognosis of glucose metabolism and its impacting factors at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy.Methods:In this cross-sectional study, a total of 192 patients with abnormal blood glucose during pregnancy enrolled and delivered in the maternity clinic of Daxing Teaching Hospital of Capital Medical University from December 1, 2019 to December 31, 2020 were collected. The 75 g oral glucose tolerance test (OGTT) was applied for diabetes screening at 6-12 weeks after delivery. According to the results of postpartum blood glucose, the patients were divided into two groups: postpartum normal blood glucose group (148 cases) and abnormal blood glucose group (44 cases). Hypothesis testing was used to compare the clinical data before, during and after the pregnancy between the two groups. Multi-factor logistic regression was performed to analyze the influencing factors of postpartum abnormal blood glucose in patients with abnormal blood glucose during pregnancy.Results:Among the 192 patients with abnormal blood glucose during pregnancy, the incidence of postpartum abnormal blood glucose was 22.92% (44/192), including 6 cases of diabetes mellitus (DM) (13.64%), 38 cases of impaired glucose tolerance (IGT) (86.36%). Neck circumference, waist circumference, multiparous women and insulin use during pregnancy in postpartum abnormal blood glucose group were all significantly higher than those in postpartum normal blood glucose group [34.25(33.00, 36.00) vs 33.55 (32.00, 35.00) cm, 87.00 (82.00, 93.00) vs 84.00 (78.00, 90.00) cm, 54.55% vs 37.16%, 18.18% vs 6.76%] (all P<0.05). Neck circumference ( OR=1.315, 95% CI: 1.026-1.685), multiparous women ( OR=2.261, 95% CI: 1.057-4.836), insulin use during pregnancy ( OR=3.767, 95% CI: 1.236-11.478) were positively correlated with the occurrence of postpartum abnormal blood glucose (all P<0.05). Conclusions:The incidence of postpartum abnormal blood glucose is high at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy. Neck circumference, waist circumference, parity and insulin use during pregnancy are important impacting factors of postpartum abnormal blood glucose.