摘要：
目的 探讨母乳喂养对妊娠糖尿病(gestational diabetes mellitus,GDM)患者罹患2型糖尿病的保护效应.方法 对660名妊娠糖尿病患者,采用前瞻性队列研究,测量其分娩后6~9周血糖水平,并进行年度随访,采集可能与2型糖尿病发生有关的信息.采用Stata 12.0与SPSS 20.0软件进行数据分析.结果 615名产妇完成了规定的随访检测,其中78名(12.7%)被新诊断患有2型糖尿病,发病率为5.919/(1000人·月);人工喂养组24名患者发展为2型糖尿病,发病率为8.153/(1000人·月);混合喂养组42名发展为2型糖尿病,发病率为5.657/(1000人·月);母乳喂养组12名发展为2型糖尿病,发病率为4.091/(1000人·月).Weibull回归模型分析显示,在平衡了相关混杂因素后,相对于人工喂养组,混合喂养组在产后2年内发展为2型糖尿病的风险为0.52(95% CI:0.28~0.89),母乳喂养组则为0.43(95% CI:0.23~0.82),两组间差异有统计学意义(P=0.023).结论 母乳喂养能有效降低GDM 产妇产后罹患2型糖尿病的风险,加强GDM产后随访与GDM产后体重控制,能有效控制GDM 产妇2型糖尿病的发生.%Objective To study the protective effect of breastfeeding on the occurrence of type 2 diabetes mellitus(T2DM) in women with gestational diabetes mellitus(GDM).Methods A total of 660 GDM women were enrolled in this prospective co-hort study.Blood glucose levels were detected 6 to 9 weeks after delivery(baseline)and then on a year basis for 2 years.The re-lated data of T2DM were collected.Stata 12.0 and SPSS 20.0 were used for data analysis.Results In total,615 women completed the follow-up tests.Seventy-eight(12.7%)were diagnosed as having T2DM,and the incidence rate was 5.919/(1000 person·month) .Twenty-four in formula feeding group were diagnosed as having T2DM,and the incidence rate was 8.153/(1000 person· month).Forty-two in mixed feeding group were diagnosed with T2DM,and the incidence rate was 5.657/(1000 person · month).Twelve in breastfeeding group were diagnosed as having T2DM,and the incidence rate was 4.091/(1000 person· month).Weibull regression model analysis showed that after adjustment of confounding factors,the hazard ratios in mixed feed-ing group and breastfeeding group versus formula feeding group were 0.52(95% CI:0.28~0.89)and 0.43(95% CI:0.23~0.82),respectively(P=0.023).Conclusion Breastfeeding can effectively reduce the risk for T2DM in GDM women.It is effec-tive to control the occurrence of T2DM by strengthening the follow-up of GDM women and postpartum weight control.
