Wahabi Hayfaa A, Esmaeil Samia A, Fayed Amel, Al-Shaikh Ghadeer, Alzeidan Rasmieh A
Sheikh Bahmdan Chair of Evidence-Based Healthcare and Knowledge Translation, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
BMC Res Notes. 2012 Sep 10;5:496. doi: 10.1186/1756-0500-5-496.
Pregnancies complicated by pre-existing diabetes mellitus (PDM) are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM.
This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH) during the period of January 1st to the 31st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period.
A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7%) women had PDM. There were 66 (57%) women with type 1 diabetes mellitus (T1DM) and 50 (43%) women with type 2 diabetes mellitus (T2DM). Compared to non-diabetic women those with PDM were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S), OR 2.67, 95% confidence intervals (CI) (1.63-4.32), P < 0.001, or elective C/S, OR 6.73, 95% CI (3.99-11.31), P < 0.001. The neonates of the mothers with PDM were significantly heavier, P < 0.001; and more frequently macrosomic; OR 3.97, 95% CI (2.03-7.65), P = 0.002. They more frequently have APGAR scores <7 in 5 minutes, OR 2.61, 95% CI (0.89-7.05), P 0.057 and more likely to be delivered at <37 gestation weeks, OR 2.24, 95% CI (1.37- 3.67), P 0.003. The stillbirth rate was 2.6 times more among the women with PDM; however the difference did not reach statistical significance, P 0.084.
PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.
妊娠合并孕前糖尿病(PDM)与高不良结局发生率相关,包括流产率增加、早产、子痫前期、围产期死亡率和先天性畸形;与背景人群相比。本研究的目的是确定PDM的患病率,并调查患有PDM的女性的孕产妇和新生儿结局。
这是一项对2008年1月1日至12月31日期间在哈立德国王大学医院(KKUH)分娩的女性进行的回顾性队列研究。将患有PDM的女性的妊娠结局与同一研究期间分娩的所有非糖尿病女性的结局进行比较。
共有3157例分娩符合纳入标准。在研究人群中,116名(3.7%)女性患有PDM。其中66名(57%)为1型糖尿病(T1DM)女性,50名(43%)为2型糖尿病(T2DM)女性。与非糖尿病女性相比,患有PDM的女性年龄显著更大,产次更高,且既往流产次数更多。患有PDM的女性更有可能通过急诊剖宫产(C/S)分娩,比值比(OR)为2.67,95%置信区间(CI)为(1.63 - 4.32),P < 0.001,或择期C/S,OR为6.73,95%CI为(3.99 - 11.31),P < 0.001。患有PDM的母亲的新生儿体重显著更重,P < 0.001;且巨大儿更常见,OR为3.97,95%CI为(2.03 - 7.65),P = 0.002。他们在5分钟时APGAR评分<7的情况更频繁,OR为2.61,95%CI为(0.89 - 7.05),P = 0.057,且更有可能在妊娠<37周时分娩,OR为2.24,95%CI为(1.37 - 3.67),P = 0.003。患有PDM的女性的死产率是其他女性的2.6倍;然而,差异未达到统计学显著性,P = 0.084。
PDM与剖宫产分娩、巨大儿、死产、早产以及5分钟时低APGAR评分的风险增加相关。