بررسی ارتباط بین غلظت هموگلوبین مادری در سه ماهه اول بارداری با دیابت حاملگی در زنان باردار

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه زنان و مامایی، مرکز سلامت بارداری، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

2 استاد گروه اپیدمیولوژی، مرکز تحقیقات ارتقاء سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

3 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

چکیده

مقدمه: دیابت، شایع‌ترین بیماری غدد درون‌ریز در حاملگی است و شناسایی عوامل خطرساز دیابت بارداری به کشف زنانی که در ابتلاء به خطر دیابت نوع ۲ در آینده قرار دارند، کمک می‌کند. مطالعه حاضر با هدف تعیین رابطه میزان هموگلوبین سه ماهه اول بارداری با دیابت بارداری در زنان باردار صورت گرفت.
روش کار: این مطالعه گذشته‌نگر در سال 98-1396 بر روی 300 پرونده زن بارداری که به مراکز درمانی شهر زاهدان مراجعه کرده بودند، انجام شد. با استفاده از چک‌لیست اطلاعاتی، مشخصات دموگرافیک نمونه‌های پژوهش از قبیل سن، قد، وزن و تعداد حاملگی و زایمان، میزان غلظت هموگلوبین مادر و FBS در اولین مراجعه به مراکز مربوطه و میزان GCT در هفته‌های 28-24 حاملگی، جمع‌آوری و ثبت گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) و آزمون‌های تی تست مستقل و آنووا انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ها: از 300 نفر جامعه آماری، 113 نفر (7/37%) دیابت بارداری و 187 نفر (3/62%) از نظر دیابت سالم بودند. از بین افراد، 103 نفر (3/34%) هموگلوبین بیشتر از 13، 42 نفر (14%) هموگلوبین 13-4/12، 79 نفر (3/26%) هموگلوبین 3/12-6/11 و 76 نفر (3/25%) هموگلوبین کمتر مساوی 5/11 داشتند. میانگین هموگلوبین در زنان باردار دیابتی 61/0±71/13 و در زنان سالم 52/0±80/11 گرم در دسی‌لیتر بود که این اختلاف از نظر آماری معنی‌دار بود (001/0>p). همچنین بین مقدار هموگلوبین و قند ناشتا همبستگی مثبت و معناداری وجود داشت (001/0>p).
نتیجه‌گیری: سطح بالای هموگلوبین (بیشتر از 13 گرم در دسی‌لیتر) در سه ماهه اول بارداری با دیابت بارداری ارتباط مستقیم و معنی‌داری دارد، بنابرین می‌توان آن را عنوان یک عامل خطر دیابت بارداری در نظر گرفت.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between maternal hemoglobin concentration in the first trimester of pregnancy and gestational diabetes

نویسندگان [English]

  • Narjes Noori 1
  • Alireza Ansari-Moghaddam 2
  • Saeed Toghi 3
1 Assistant Professor, Department of Obstetrics and Gynecology, Pregnancy Health Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
2 Professor, Department of Epidemiology, Health Promotion Research Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
3 General practitioner, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
چکیده [English]

Introduction: Diabetes is the most common endocrine disease in pregnancy and identifying the risk factors for gestational diabetes helps to identify women who are at risk for type 2 diabetes in the future. The present study was performed aimed to determine the relationship between maternal hemoglobin concentration in the first trimester of pregnancy and gestational diabetes in pregnant women.
Methods: This retrospective study was performed on 300 cases of pregnant women who referred to medical centers of Zahedan in 2017-2019. The information checklist was used to collect demographic characteristics of research samples such as age, height, weight and number of pregnancies and deliveries, maternal hemoglobin and FBS concentrations at the first visit to the relevant centers and GCT levels in 24 to 28 weeks of pregnancy. Data were analyzed by SPSS statistical software (version 25) and Independent t-test and ANOVA tests. P<0.05 was considered statistically significant.
Results: Out of 300 women in the statistical population, 113 (37.7%) had gestational diabetes and 187 (62.3%) were healthy in terms of diabetes. Of the subjects, 103 (34.3%) had hemoglobin concentrations greater than 13, 42 (14%) had hemoglobin concentrations 12.4 to 13, 79 (26.3%) had hemoglobin concentrations between 11.6 to 12.3, and 76 (25.3%) had hemoglobin concentrations less than 11.5. The mean hemoglobin level in diabetic pregnant women was 13.71 ± 0.61 g/dl and in healthy women was 11.80 ± 0.52 g/dl, and the difference was statistically significant (P <0.001). There was also a positive and significant correlation between hemoglobin and fasting blood sugar levels (P <0.001).
Conclusion: High hemoglobin level (more than 13 g/dl) in the first trimester of pregnancy is significantly and directly related to gestational diabetes, therefore it can be considered as a risk factor for gestational diabetes.

کلیدواژه‌ها [English]

  • First trimester
  • Gestational diabetes
  • HbA1c

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 7
مهر 1401
صفحه 39-44

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