| Abstract: | 本研究主要目的是針對台灣地區2004-2009年期間罹患孕前糖尿病或疑似糖尿病，且為第一胎單胎妊娠之婦女，分析其所產下之新生兒先天性缺陷之風險；並且探討母親及新生兒特質與先天性缺陷之相關性。
本研究使用2004-2009年出生通報檔、全民健康保險研究資料庫及出生登記檔進行分析。對象為生產胎次為第一胎，且為單胎妊娠之本國非糖尿病、疑似糖尿病及孕前糖尿病之產婦，全體樣本共計621, 008人；統計分析方法包括：描述性統計以及邏輯斯迴歸分析。
本研究之重要發現如下：孕前糖尿病或疑似糖尿病患者，皆顯著提高後代先天性缺陷之風險；尤其是孕前糖尿病婦女，其相較於非糖尿病婦女，顯著提高各系統缺陷之風險，包括神經系統缺陷、眼部缺陷、心臟系統缺陷、呼吸系統缺陷、口面裂、消化系統缺陷、泌尿系統缺陷、四肢缺陷及其他未被歸納於各系統之缺陷風險。
在分析母親年齡、新生兒性別、妊娠週數、新生兒出生體重、新生兒出生後第一分鐘及第五分鐘的Apgar score與先天性缺陷之相關性部份；經由單變項邏輯斯迴歸分析發現非糖尿病、疑似糖尿病及孕前糖尿病三組皆顯示：隨著妊娠週數、新生兒出生體重及出生後第一分鐘與第五分鐘Apgar score的增加，則先天性缺陷之風險會降低；但在母親年齡方面則顯示，母親年齡愈高，則後代患有先天性缺陷之機率也隨之提升；且分析結果發現：非糖尿病與疑似糖尿病之婦女，其所產下之新生兒若為男嬰，則患有先天性缺陷之風險顯著高於女嬰。
婦女於懷孕前罹患糖尿病，或者為疑似糖尿病患者，是增加後代先天性缺陷之重要因素；而母親年齡、妊娠週數、新生兒出生體重及新生兒出生後第一分鐘與第五分鐘的Apgar score與先天性缺陷具有顯著關係；希望藉由本研究之發現，能喚起衛生機關重視糖尿病婦女妊娠期間之保護措施，並且制定相關政策以降低糖尿病所帶來之不良妊娠發病率。
The study subjects in this research were women and their first offsprings. Women who suffered pregestational diabetes or suspected diabetes during 2004 to 2009 and their first offsprings were included to explore the risk factors of birth defects, and the association between mothers’ health and babies’ birth defects.
The Birth Certificate Application, National Health Insurance Research Database, and the Birth Registration databasewere linked into the study dataset.The samples of this research are 621,008 pregnant women. Descriptive statistics and logistic regression analysis were used to analyze the dataset.
The major findings of this study are as follows:women suffering from pregestational diabetes or suspected diabetes aresignificantlyassociated with the birth defectsof their firstoffsprings. In addition, the first offsprings of women who suffer frompregestational diabeteshad higher risk of birth defects than the mothers who did not have diabetes mellitus. The higher risk of birth defects include: the nervous system defects, eyes defects, heart defects, respiratory system defects, orofacial cleft,digestive defects, urinary tract defects, limb defects, andother defects.
In the further analysis of therelationship between neonates gender, maternal age, gestational weeks, birth weight, Apgar scoreandbirth defects by univariate logistic regression analysis found that,non-diabetes and pregestational diabetes and suspected diabetes groups indicate that, with the increasing number of gestationweeks, birth weight, the Apgar scoreof the first minute and the fifth minute of newborn,the risk of birth defectsprones to decrease;with the increase of maternal age,the risk of birth defects also prones to increase; another finding in this research is that the risk of birth defects in boysare significantly higher than girls.
In conclusion, women with pregestational diabetes, or suspected diabetics is the factor of increasingthe risk of birth defects in the offspring, while maternal age, gestational age, birth weight, and the Apgar scoreof the first minute and the fifth minute of newborns has a significant relationship with birth defects. |
