Thanasuan Sornlada, Borriboonhirunsarn Dittakarn
Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2006 Aug;89(8):1109-14.
To compare the incidence of Gestational Diabetes Mellitus (GDM) between pregnant women with one abnormal value of oral glucose tolerance test (Study group) and those with normal screening test (Control group) and compare their pregnancy outcomes.
Retrospective cohort study.
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital.
Two hundred and twenty eight at-risk pregnant women were enrolled from January 2003 to November 2004. They were divided equally with 114 each in study and control group. All received GDM screening before 24 weeks of gestation following the guidelines used at Siriraj Hospital. Data collection included baseline characteristics, data on clinical risks and screening results, final diagnosis, maternal and neonatal complications. Incidence of GDM and pregnancy outcomes was compared between the two groups.
Both groups' baseline characteristics and clinical risks were comparable, except that the mean age of women in the study group was significantly greater than in the control group (32.8 +/- 4.9 and 29.7 +/- 5.5 years, p < 0001). The incidence of GDM was significantly higher among in study group compared with the control group (21.9% and 1.8% respectively, RR 12.5, 95%CI 3.0-51.5). After adjusting for maternal age, abnormal one OGTT value was the only independent risk for developing GDM (adjusted OR 16.3, 95%CI 3.7-71.9, p < 0.001). Infants of the study group had significantly higher birth weight than those of the control group (3203.6 +/- 563.9 and 3050.7 +/- 457.8 g respectively, p = 0.026). Rate of primary cesarean section, asphyxia, macrosomia, low birth weight, and other neonatal complications were comparable between the two groups.
Pregnant women with one abnormal value of oral glucose tolerance test had a significantly greater risk of developing GDM compared to women with normal screening test. Pregnancy outcomes between the two groups were not significantly different.
比较口服葡萄糖耐量试验有一项异常值的孕妇（研究组）和筛查试验正常的孕妇（对照组）之间妊娠期糖尿病（GDM）的发生率，并比较她们的妊娠结局。
回顾性队列研究。
诗里拉吉医院医学院妇产科。
2003年1月至2004年11月纳入228名高危孕妇。她们被平均分为研究组和对照组，每组114名。所有孕妇均按照诗里拉吉医院使用的指南在妊娠24周前接受GDM筛查。数据收集包括基线特征、临床风险数据和筛查结果、最终诊断、母婴并发症。比较两组之间GDM的发生率和妊娠结局。
两组的基线特征和临床风险具有可比性，但研究组女性的平均年龄显著高于对照组（分别为32.8±4.9岁和29.7±5.5岁，p<0.001）。研究组中GDM的发生率显著高于对照组（分别为21.9%和1.8%，RR 12.5，95%CI 3.0 - 51.5）。在调整孕妇年龄后，一项OGTT值异常是发生GDM的唯一独立风险因素（调整后OR 16.3，95%CI 3.7 - 71.9，p<0.001）。研究组婴儿的出生体重显著高于对照组（分别为3203.6±563.9克和3050.7±457.8克，p = 0.026）。两组之间的初次剖宫产率、窒息、巨大儿、低出生体重和其他新生儿并发症发生率相当。
与筛查试验正常的女性相比，口服葡萄糖耐量试验有一项异常值的孕妇发生GDM的风险显著更高。两组之间的妊娠结局没有显著差异。
