Rehder Patricia Moretti, Pereira Belmiro Gonçalves, Silva João Luiz Pinto e
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brasil.
Rev Bras Ginecol Obstet. 2011 Feb;33(2):81-6.
to determine the prevalence of adverse gestational and neonatal outcomes in women with a positive screening and negative diagnosis for gestational diabetes mellitus (GDM).
a retrospective descriptive cross-sectional study was conducted from 2000 to 2009 on 409 women with positive screening for GDM. The maternal variables studied were: age, body mass index, history of cesarean section, macrosomia or diabetes mellitus in a previous pregnancy and a personal or family history of diabetes mellitus and chronic arterial hypertension. The neonatal variables studied were: polyhydramnios, gestational age at birth, prematurity, cesarean delivery, large for gestational age (LGA) newborn, macrosomia, Apgar score, neonatal respiratory distress syndrome, hypoglycemia and hyperbilirubinemia. Uni- and multivariate descriptive analyses were first performed regarding risk factors and neonatal outcome and the prevalences and respective 95% confidence intervals were determined.
the route of delivery was cesarian section in 255 cases (62.3%), preterm birth occurred in 14.2% of cases and 19.3% of the newborns were LGA. The risk factors correlated with LGA newborns were overweight or obesity, maternal age and a history of macrosomia in a previous pregnancy.
a high rate of LGA newborns was observed in the population with positive risk factors or altered fasting glycemia on the occasion of the first prenatal visit, even when the glycemia curve was normal, with cesarean rates above those habitually observed in populations considered to be of low risk. Pregnant women with these characteristics represent a differential group.
确定妊娠期糖尿病（GDM）筛查阳性但诊断阴性的女性中不良妊娠和新生儿结局的发生率。
对2000年至2009年409例GDM筛查阳性的女性进行回顾性描述性横断面研究。研究的母亲变量包括：年龄、体重指数、剖宫产史、既往妊娠中的巨大儿或糖尿病以及糖尿病和慢性动脉高血压的个人或家族史。研究的新生儿变量包括：羊水过多、出生时的孕周、早产、剖宫产、大于胎龄（LGA）新生儿、巨大儿、阿氏评分、新生儿呼吸窘迫综合征、低血糖和高胆红素血症。首先对危险因素和新生儿结局进行单变量和多变量描述性分析，并确定发生率和各自的95%置信区间。
255例（占62.3%）为剖宫产分娩，14.2%的病例发生早产，19.3%的新生儿为LGA。与LGA新生儿相关的危险因素为超重或肥胖、母亲年龄以及既往妊娠中的巨大儿病史。
在首次产前检查时，即使血糖曲线正常，但具有危险因素阳性或空腹血糖异常的人群中观察到较高比例的LGA新生儿，剖宫产率高于被认为是低风险人群中通常观察到的剖宫产率。具有这些特征的孕妇代表了一个特殊群体。
