Bilinen ve Olası Risk Faktörlerinin Birlikteliğinin Gestasyonel Diabetes Mellitus Gelişimine Etkisi
Amaç: Çalışmamızda gestasyonel diabetes mellitus (GDM) gelişimine etki edebileceği düşünülen riskfaktörlerini değerlendirmeyi amaçladık.Materyal ve Metot: GDM taraması yapılan gebelerde yapılandırılmış anket formu ile vaka‐kontrolçalışması planlandı. Bu amaçla Ocak‐Ekim 2017 tarihleri arasında Hatay Devlet Hastanesi kadınhastalıkları ve doğum polikliniğine başvuran gebe hastalar çalışmaya dahil edildi. İki basamaklı oralglukoz tolerans testi (OGTT) uygulanmış 181 kayıt tarandı. Verilerine ulaşılan 102 katılımcıdeğerlendirildi. Çalışmamızda veriler %95 güvenle, SPSS 22 (Statistical Package for the Social Sciences)paket programı kullanılarak istatistiki olarak analiz edildi. Kullanılan bütün testlerin anlamlılık sınırı0,05 olarak belirlendi. Çalışmada genel olarak Pearson‐Continuity Correction‐Fisher Exact Chi‐Squaretestleri, çok değişkenli lojistik regresyon (enter metot) analizleri kullanıldı.Bulgular: 102 katılımcımızın 74 (72,50)’i GDM olmayan, 28 (27,50)’i GDM olan gebelerdi. Yaşortalamaları (yıl) 29,04 ± 6,11 idi. GDM ile tek değişkenli ilişkiler araştırıldığında yaş (p=0,001), dahaönceki gebeliklerinde GDM’li olma durumu (p=0,002), birinci derece yakınlarında diyabet öyküsü varlığı(p=0,001), gebelikte alınan kilo (p=0,011), gebelik öncesi glukozüri anamnezi (p=0,020), gebelik sayısıartışı (p=0,012), makrozomik bebek doğurma öyküsü olanlarda (p=0,027) GDM ile anlamlı ilişkibulunmuştur. Ancak risk faktörlerinin önemleri birlikte değerlendirildiğinde ilerleyen yaş, artmışgebelik sayısı ve birinci derece yakınında diabetes mellitus (DM) varlığı GDM riskini artırmaktadır.Beden kitle indeksi (BKİ) ve ilk iki trimesterde alınan kilonun >8 kg olması anlamlılıkoluşturmamaktadır.Sonuç: Birinci derece yakınında DM varlığı, artmış maternal yaşla birlikte BKİ ve doğum sayısında artışGDM riskini artırmaktadır. Prenatal taramada bu risk faktörlerinin dikkate alınması gerekmektedir.
The Effect of Common and Possible Risk Factors’ Co‐occurrence to the Development of Gestational Diabetes Mellitus
Objectives: Advanced maternal age, obesity, presence of family history of diabetes and macrosomic infant delivery are common risk factors for gestational diabetes (GDM). The increase in pregnancy weight and number of pregnancies are also possible risk factors. The purpose of this study was to assess the association of common and possible risk factors with GDM development. Materials and Methods: A case‐control study was planned with a structured questionnaire on GDM screening. For this purpose, pregnant patients who applied to the Hatay State Hospital gynecology and obstetric outpatient clinic between January and October 2017 were included in the study. 181 case records who were applied a two‐step oral glucose tolerance test (OGTT) were scanned. 102 participants were included in this study. In our study, the data were analyzed statistically using 95% confidence, using the SPSS 22 (Statistical Package for the Social Sciences) package program. The significance level of all the tests used was determined to be 0.05. Pearson‐Continuity Correction‐Fisher Exact Chi‐Square tests, binary logistic regression (enter method) analyzes were used in the study. Results: 74 of our 102 participants (72.50%) were non‐GDM and 28 (27.50%) were GDM. The average age is 29.04 ± 6.11. Univariate relations with GDM are investigated, age (p=0.001), prevalence of GDM at previous pregnancies (p=0.002), presence of diabetes mellitus family history (p=0.001), increase of body weight in pregnancy (p=0.011), presence of glycosuria before pregnancy (p= 0.020), multiple pregnancies (p=0.012), presence of macrosomic baby delivery (p=0.027). However, when the significance of risk factors is evaluated together with logistic regression analysis, advancing maternal age, multiple pregnancies and presence of diabetes mellitus family history increases the risk of GDM. Body mass index (BMI) and the weight of the first two trimester weight> 8 kg are not significant. Conclusion: Presence of diabetes mellitus family history, increased maternal age together with BMI, multiple pregnancies increases GDM risk. These risk factors need to be considered in prenatal screening.
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