基于倾向性得分匹配法分析胎膜早破对妊娠期糖尿病孕妇新生儿结局的影响

Effect of premature rupture of membranes in pregnant women with gestational diabetes mellitus on neonatal outcomes based on propensity score matching

黄蒨 ¹徐竟琪 ¹徐荣 ¹田瑞雪 ¹邹智杰 ¹陈晓莉 ¹陈真 ²刘文惠³

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作者信息

1. 武汉大学护理学院湖北武汉 430071
2. 重庆市妇幼保健院重庆 401174
3. 武汉大学中南医院妇产科湖北武汉 430071
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摘要

目的:通过倾向性匹配(PSM)的方法探讨胎膜早破(PROM)对妊娠期糖尿病(GDM)孕妇新生儿结局的影响.方法:选取2017年7月至2020年6月在重庆市某妇幼医院分娩且有活产结局的5 656例单胎妊娠期糖尿病孕妇,将妊娠期糖尿病孕妇分为胎膜早破组和对照组.通过倾向性匹配对基线特征进行1∶1匹配,比较两组妊娠期糖尿病孕妇新生儿不良结局发生率的差异.匹配前后数据采用Logistic回归分析胎膜早破与新生儿不良结局之间的关联.结果:倾向性匹配后,胎膜早破组和对照组各纳入妊娠期糖尿病孕妇1 531例,匹配后两组间协变量均衡(P>0.05);Logistic回归分析结果显示,胎膜早破会增加妊娠期糖尿病孕妇的早产[调整后的比值比(AOR)(95%CI):4.855(3.563～6.741),P<0.001]、低出生体质量儿[AOR(95%CI):2.648(1.862～3.831),P<0.001]和新生儿高胆红素血症[AOR(95%CI):2.073(1.576～2.745),P<0.001]的发生风险,但降低了巨大儿[AOR(95%CI):0.568(0.393～0.813),P<0.05]的发生风险.结论:发生胎膜早破的妊娠期糖尿病孕妇新生儿出现并发症的风险较高,如早产、低出生体质量、高胆红素血症等.

Abstract

Objective:To explore the effect of premature rupture of membranes(PROM)on neonatal out-comes in pregnant women with gestational diabetes mellitus(GDM)by propensity score matching(PSM).Methods:A total of 5 656 singleton GDM pregnant women who delivered at a maternal and child hospital in Chongqing from July 2017 to June 2020 with live birth outcomes were selected,and the GDM pregnant women were divided into the PROM group and control group.Baseline characteristics of women with GDM and neonates were matched 1∶1 by PSM,and the difference in the incidence of adverse neonatal outcomes between the two groups of GDM pregnant women was compared.Logistic regression was used to analyze pre-matching and post-matching data to explore the association between PROM and adverse neonatal outcomes.Results:After PSM,1 531 pregnant women with GDM were enrolled in PROM groups and control group,and the covariates were balanced between the two groups after matching(P>0.05);the results of logistic regression analyses indicated that PROM increased the risk of preterm birth(AOR(95%CI):4.855(3.563-6.741),P<0.001),low birth weight infants(AOR(95%CI):2.648(1.862-3.831),P<0.001)and neonatal hy-perbilirubinemia(AOR(95%CI):2.073(1.576-2.745),P<0.001)in pregnant women with GDM,but the risk of macrosomia(AOR(95%CI):0.568(0.393-0.813),P<0.05)was reduced.Conclu-sion:Pregnant women with GDM who develop PROM have a higher risk of neonatal complications such as preterm birth,low birth weight,and neonatal hyperbilirubinemia in newborns.

关键词

妊娠期糖尿病/胎膜早破/倾向性匹配/新生儿结局/孕妇

Key words

Gestational Diabetes Mellitus/Premature Rupture of Membranes/Propensity Score Matching/Neonatal Outcome/Pregnant Women

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出版年

2024

武汉大学学报(医学版)

武汉大学

武汉大学学报(医学版)

CSTPCD

影响因子：0.959

ISSN：1671-8852

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