Szymanska Monika, Horosz Edyta, Szymusik Iwona, Bomba-Opon Dorota, Wielgos Miroslaw
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
Neuro Endocrinol Lett. 2011;32(6):885-8.
Increasing number of pregnancies resulting from In vitro Fertilisation (IVF) combined with increased awareness of Gestational Diabetes Mellitus (GDM) - related morbidity calls for research on possible differences in pregnancy outcomes between IVF and non-IVF GDM complicated pregnancies. The aim of this study was to compare GDM - affected pregnancies, both resulting from IVF and conceived without medical intervention with regards to maternal data, fetal biometry and neoanatal outcomes.
We used our Clinic's databases to retrospectively identify 36 women who had successful IVF and developed GDM during the course of their singleton pregnancy (IVF group) and 137 non-IVF women with GDM (non-IVF group). They were matched according to age, pre-pregnancy BMI and none had the history of diabetes mellitus before their pregnancies. We compared the maternal characteristics, course of pregnancy and neonatal outcome.
The weight gain until the diagnosis of GDM in both non-IVF and IVF groups of women was not significantly different (9.81±4.37 vs 10.0±4.8 kg, p=0.8 respectively) with similar time at which they came under the specialist GDM care (29±4.0 vs 28±4.5 wks, p=0.42,). When analyzing first trimester fasting glucose levels we found it to be significantly higher in IVF group (89±16.2 vs 83±11.3 mg/dl, p=0.04). Second trimester oral glucose tolerance test (OGTT) results and glucose levels during GDM treatment did not differ between the groups. No changes were noted in investigated fetal and neonatal variances: 3rd trimester AC, it's percentile and neonatal birth weight (3 460±641 vs 3 200±440 g, p=0.22).
GDM among women after in vitro fertilisation is characterised by higher first trimester fasting glucose levels. Early diagnostic intervention in IVF pregnancies is specially needed.
体外受精（IVF）导致的妊娠数量不断增加，同时妊娠期糖尿病（GDM）相关发病率的知晓率提高，这就需要研究IVF妊娠与非IVF妊娠合并GDM的妊娠结局可能存在的差异。本研究的目的是比较受GDM影响的妊娠，包括IVF妊娠和未经医学干预受孕的妊娠，比较其母体数据、胎儿生物测量和新生儿结局。
我们使用本诊所的数据库，回顾性地确定36名单胎妊娠期间成功进行IVF并患GDM的女性（IVF组）和137名患GDM的非IVF女性（非IVF组）。根据年龄、孕前BMI进行匹配，且她们在怀孕前均无糖尿病病史。我们比较了母体特征、妊娠过程和新生儿结局。
非IVF组和IVF组女性在诊断GDM前的体重增加无显著差异（分别为9.81±4.37 vs 10.0±4.8kg，p = 0.8），接受GDM专科护理的时间相似（29±4.0 vs 28±4.5周，p = 0.42）。分析孕早期空腹血糖水平时，我们发现IVF组显著更高（89±16.2 vs 83±11.3mg/dl，p = 0.04）。两组之间孕中期口服葡萄糖耐量试验（OGTT）结果和GDM治疗期间的血糖水平无差异。所研究的胎儿和新生儿差异无变化：孕晚期腹围、其百分位数和新生儿出生体重（3460±641 vs 3200±440g，p = 0.22）。
体外受精后女性的GDM特征是孕早期空腹血糖水平较高。IVF妊娠特别需要早期诊断干预。
