Easmin S, Chowdhury T A, Islam M R, Beg A, Jahan M K, Latif T, Dhar S, Alam M N, Akhter M
Dr Sabina Easmin, Junior Consultant, Obs & Gynae, Upazilla Health Complex (UHC), Trishal, Mymensingh, Bangladesh.
Mymensingh Med J. 2015 Jul;24(3):450-6.
Obstetric outcome in early onset and late onset GDM was compared in a prospective study conducted at the Department of Obstetrics & Gynecology in BIRDEM, Dhaka, Bangladesh. A total 120 pregnant women were recruited purposively for the study in which 60 were early onset GDM and 60 were late onset GDM during study period of January 2008 to December 2009. Patients were followed up in different periods of gestation, during delivery and early postpartum period & findings were compared between two groups. BMI & family history of diabetes were significantly higher in early GDM group (p<0.05). Evidence of increased glycaemia was observed in early GDM group & difference of glycaemic status was statistically significant (p<0.05). Insulin was needed in 85% of early onset GDM and 55% in late onset GDM. There was also significant difference (p<0.05). In this study, 23.3% of early onset GDM group developed pre-eclampsia while in late onset GDM it was 10% and was statistically significant (p<0.05). Regarding intrapartum & postpartum complications - perineal tear, PPH wound infection, puerperal sepsis were more in early onset than late onset GDM group with no significant difference. Regarding foetal outcome, 8.3% early GDM group delivered asphyxiated baby in comparison to 3.3% in late GDM group. Twenty percent (20%) of early onset GDM group had to admit their babies in neonatal unit while in late onset group it was 5%. There was significant difference between two groups (p<0.05). Neonatal hypoglycaemia was also statistically significantly (p<0.05) higher in early GDM group. Neonatal hyper-bilirubinaemia, RDS, perinatal death was more in early onset GDM subjects. Early onset GDM subjects are high risk subgroup & have significant deleterious effect on maternal and perinatal outcome than late GDM groups.
在孟加拉国达卡BIRDEM妇产科进行的一项前瞻性研究中，比较了早发型和晚发型妊娠期糖尿病（GDM）的产科结局。在2008年1月至2009年12月的研究期间，共有120名孕妇被有目的地招募入组，其中60例为早发型GDM，60例为晚发型GDM。在妊娠的不同时期、分娩期间及产后早期对患者进行随访，并比较两组的研究结果。早发型GDM组的体重指数（BMI）和糖尿病家族史显著更高（p<0.05）。早发型GDM组观察到血糖升高的证据，血糖状态差异具有统计学意义（p<0.05）。85%的早发型GDM患者需要使用胰岛素，晚发型GDM患者为55%。差异也具有统计学意义（p<0.05）。在本研究中，23.3%的早发型GDM组发生了子痫前期，而晚发型GDM组为10%，具有统计学意义（p<0.05）。关于产时及产后并发症——早发型GDM组的会阴撕裂、产后出血、伤口感染、产褥期败血症比晚发型GDM组更多，但无显著差异。关于胎儿结局，早发型GDM组有8.3%分娩出窒息婴儿，晚发型GDM组为3.3%。20%的早发型GDM组不得不将其婴儿送入新生儿病房，而晚发型GDM组为5%。两组之间存在显著差异（p<0.05）。早发型GDM组新生儿低血糖也具有统计学显著升高（p<0.05）。早发型GDM患者的新生儿高胆红素血症、呼吸窘迫综合征（RDS）、围产期死亡更多。早发型GDM患者是高危亚组，与晚发型GDM组相比，对孕产妇和围产儿结局有显著的有害影响。
