Brankica Krstevska, Valentina Velkoska Nakova, Slagjana Simeonova Krstevska, Sasha Jovanovska Mishevska
Endocrinology Diabetes and Metabolic Disorders Clinic, Medical Faculty, Skopje, R. Macedonia.
Faculty of Medical Science, Goce Delcev University, Stip, R. Macedonia.
Arch Endocrinol Metab. 2016 Feb;60(1):36-41. doi: 10.1590/2359-3997000000126.
Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM).
The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients' ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight.
From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels).
Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies.
我们的目标是研究75克口服葡萄糖耐量试验（OGTT）中的哪种血糖测量值更能预测妊娠期糖尿病（GDM）母亲的大于胎龄（LGA）新生儿。
研究组由内分泌、糖尿病和代谢紊乱门诊连续收治的118名单胎妊娠孕妇组成。所有孕妇均在妊娠第24至28周进行GDM的前瞻性筛查，并随访至分娩。观察指标包括：患者年龄、孕前体重指数、分娩前体重指数、空腹血糖（FPG）、OGTT 1小时和2小时血糖值、孕晚期糖化血红蛋白、分娩孕周、分娩方式和婴儿出生体重。
118例妊娠中，78例（66.1%）为GDM患者，40例（33.9%）无GDM。GDM组和对照组的LGA新生儿之间存在统计学显著差异（分别为30.7%和5.0%，p<0.01）。分娩孕周和空腹血糖水平是LGA的独立预测因素（β分别为0.58和0.37，p<0.01）。比较了预测LGA的受试者工作特征曲线（AUC）下面积（空腹血糖为0.782（0.685 - 0.861），1小时血糖为0.719（0.607 - 0.815），2小时OGTT血浆葡萄糖水平为0.51（0.392 - 0.626））。
OGTT中的空腹和1小时血浆葡萄糖水平可预测GDM妊娠中的LGA婴儿。
