妊娠糖尿病患者负性情绪及危险因素分析

Analysis of negative emotion and risk factors in gestational diabetes mellitus

摘要:

目的 调查妊娠糖尿病（GDM）患者负性情况的发生状况，并分析其危险因素。方法 选取2014 年 6 月—2016 年6 月海南省人民医内分泌科就诊的GDM 患者189 例，根据医院用焦虑抑郁量表（HADS）评分 结果，分为GDM 合并负性情绪组（GDM+ 负性情绪组，HADS>15 分）Ⅲ例和GDM 不合并负性情绪组（GDM 组，HADS ≤ 15 分）88 例。另根据HADS 评分将GDM+ 负性情绪组分为轻度负性情绪亚组（16 ≤ HADS ≤ 20） 39 例、中度负性情绪亚组（21 ≤ HADS ≤ 30）37 例及重度负性情绪亚组（31 ≤ HADS ≤ 42）35 例。采 用Pearson 相关分析HADS 评分水平的相关因素。采用Logistic 回归分析GDM 患者合并负性情绪的影响因 素。结果 ① GDM 患者合并负性情绪的发生率为58.73%（111/189）。GDM+ 负性情绪组孕前BMI、FPG、 HbA1c、TC、TG、HDL-C、HOMA-IR 及糖尿病家族史患者比例均高于GDM 组（P <0.05）；②重度负性 情绪亚组FPG、HbA1c、TC、TG、HDL-C 及HOMA-IR 水平均高于轻度负性情绪亚组和中度负性情绪亚组， 且中度负性情绪亚组FPG、HbA1c、TC 及HOMA-IR 水平高于轻度负性亚组（P <0.05）；③ Pearson 相关分 析显示，孕前BMI、孕期体重增加、FPG、HbA1c、TC、TG、HDL-C、HOMA-IR 及有糖尿病家族史均与 HADS 评分相关（P <0.05）；④孕前BMI、孕期体重增加、HbA1c 及糖尿病家族史是GDM 合并负性情绪的 危险因素（P <0.01）。结论 GDM 患者合并负性情绪的发生率仍较高，尤其是孕前BMI 高、孕期体重增加、 HbA1c 水平高及有糖尿病家族史的患者。因此，对该类孕妇应及早的进行心理干预，提供更多的心理辅导， 预防负性情绪的发生。

Abstract:

Objective To investigate the occurrence condition of gestational diabetes mellitus (GDM) with negative emotion, and to analyze its risk factors. Methods A total of 189 patients with GDM in our hospital form Jun. 2014 to Jun. 2016 were divided into two groups according to Hospital Anxiety and Depression Scale (HADS) score: GDM + negative emotion group (n = 111, HADS > 15) and GDM group (n = 88, HADS ≤ 15). In addition, the subjects in GDM + negative emotion group were divided into mild subgroup (n = 39, 16 ≤ HADS ≤ 20), medium subgroup (n = 37, 21 ≤ HADS ≤ 30) and severe subgroup (n = 35, 31 ≤ HADS ≤ 42) according to the HADS level. The association between HADS scores and other metabolic indicators was analyzed by Pearson correlation analysis. Logistic regression analysis was adopted to assess the influence factors for HADS levels in GDM patients with negative emotion. Results ① In this study, the incidence rate of GDM patients with negative emotion was 58.73% (111/189). The pre-pregnancy BMI, FPG, HbA1c, TC, TG, HDL-C, HOMA-IR levels and DM family history ratio were higher in GDM + negative emotion group than those in GDM group (P < 0.05); ② The FPG, HbA1c, TC, TG, HDL-C and HOMA-IR levels were higher in severe subgroup than those in mild subgroup and in medium subgroup, and the FPG, HbA1c, TC and HOMA-IR levels were higher in medium subgroup than those in mild subgroup (P < 0.05); ③ Pearson correlation analysis showed that the pre-pregnancy BMI, weight gain, FPG, HbA1c, TC, TG, HDL-C, HOMA-IR levels and DM family history ratio were related factors for HADS scores (P < 0.05); ④ Logistic regression analysis showed that pre-pregnancy BMI, weight gain, HbA1c levels and DM family history ratio were risk factors for GDM patients with negative emotion (all P < 0.01). Conclusion The incidence rate of negative emotion is higher in GDM patients, and in particular, the patients with high levels of pre-pregnancy BMI, high weight gain, high HbA1c and with family history of diabetes. Therefore, it is necessary to intervene early and provide more psychological counseling for preventing the occurrence of negative emotions.