摘要
目的基于焦虑-抑郁-社会支持特征对妊娠糖尿病(GDM)患者进行潜在剖面分析(LPA),识别低血糖风险亚组及影响因素。方法选取2022年10月至2023年2月就诊于珠海市妇幼保健院的279例GDM患者作为研究对象,采用焦虑自评量表、爱丁堡产后抑郁量表及社会支持评定量表评估其心理社会特征,通过LPA划分亚组,结合低血糖发生情况,采用多因素logistic回归分析低血糖影响因素。结果经LPA划定C1组(低抑郁-低焦虑-高支持组)与C2组(高焦虑-高抑郁-低支持组)两个亚组。C2组低血糖发生率高于C1组,差异有统计学意义(P<0.05)。单因素分析结果显示,受孕方式、胎儿数量、血糖监测频率、睡前1~2 h未加餐、体重周增长不足及亚组分类均与低血糖发生有关(P<0.05)。多因素logistic回归分析结果显示,C2亚组(β=0.983,OR=2.673,95%CI:1.127~6.339)及未自我监测血糖(β=1.031,OR=2.803,95%CI:1.118~7.030)是低血糖发生的独立危险因素(P<0.05),自然受孕(β=-0.965,OR=0.381,95%CI:0.158~0.922)是其独立保护因素(P<0.05)。结论基于焦虑-抑郁-社会支持特征的LPA模型可精准识别GDM患者低血糖高风险亚组(C2组),临床需针对性强化心理干预与血糖管理,并重视胚胎移植受孕及规律监测血糖的保护作用,优化低血糖防控策略。
Objective To conduct a latent profile analysis(LPA)of patients with gestational diabetes mellitus(GDM)based on the anxiety-depression-social support characteristics,and identify subgroups of hypoglycemia risk and influencing factors.Methods A total of 279 patients with GDM who visited Zhuhai Center for Maternal and Child Health Care from October 2022 to February 2023 were selected as the research subjects.Their psychosocial characteristics were evaluated using the self-rating anxiety scale,the Edinburgh postnatal depression scale,and the social support rating scale.Subgroups were divided by LPA,and combined with the occurrence of hypoglycemia,multivariate logistic regression analysis was used to analyze the influencing factors of hypoglycemia.Results Two subgroups,namely group C1(low depression-low anxiety-high support group)and group C2(high anxiety-high depression-low support group)were delineated by LPA.The incidence of hypoglycemia in group C2 was higher than that in group C1,the difference was statistically significant(P<0.05).The results of univariate analysis showed that the mode of conception,the number of fetuses,the frequency of blood glucose monitoring,no snack 1-2 hours before bedtime,insufficient weekly weight gain and subgroup classification were all related to the occurrence of hypoglycemia(P<0.05).The results of multivariate logistic regression analysis showed that subgroup C2(β=0.983,OR=2.673,95%CI:1.127-6.339)and non-self-monitored blood glucose(β=1.031,OR=2.803,95%CI:1.118-7.030)were independent risk factors for hypoglycemia(P<0.05),and natural conception(β=-0.965,OR=0.381,95%CI:0.158-0.922)was an independent protective factor(P<0.05).Conclusion The LPA model based on the anxiety-depression-social support characteristics can accurately identify the high-risk subgroup(group C2)of hypoglycemia in patients with GDM.Clinically,targeted psychological intervention and blood glucose management need to be strengthened,and the protective role of embryo transfer conception and regular blood glucose monitoring should be emphasized to optimize the prevention and control strategy of hypoglycemia.
作者
杨洁梅
贝雪娜
郭彬彬
彭融融
王利枝
刘彩霞
YANG Jiemei;BEI Xuena;GUO Binbin;PENG Rongrong;WANG Lizhi;LIU Caixia(Department of Obstetrics,Zhuhai Center for Maternal and Child Health Care,Guangdong Province,Zhuhai519000,China;Department of Nursing,Zhuhai Center for Maternal and Child Health Care,Guangdong Province,Zhuhai519000,China)
出处
《中国当代医药》
2025年第23期16-20,26,共6页
China Modern Medicine
基金
广东省珠海市社会发展领域科技计划项目(一般项目)(2220004000318)。
关键词
妊娠糖尿病
焦虑
抑郁
社会支持
低血糖
影响因素
潜在剖面分析
Gestational diabetes mellitus
Anxiety
Depression
Social support
Hypoglycemia
Influencing factors
Latent profile analysis
