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100克口服葡萄糖耐量试验期间的反应性低血糖是否会对围产期结局产生不利影响?

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

作者信息

Delibas Ilhan Bahri, Tanriverdi Sema, Cakmak Bulent

出版信息

Ginekol Pol. 2018;89(1):25-29. doi: 10.5603/GP.a2018.0005.

DOI:10.5603/GP.a2018.0005
PMID:29411343
Abstract

OBJECTIVES

To determine whether pregnant women who have reactive hypoglycemia during the 100 g oral glucose toler-ance test (OGTT) are at an increased risk of poor pregnancy outcomes.

MATERIAL AND METHODS

We retrospectively analyzed perinatal data from 413 women who underwent a 3 h OGTT at 24-28 weeks of gestation and gave birth in our clinics between January 2012 and December 2014.

RESULTS

According to OGTT results, the majority of the subjects were normoglycemic (n = 316, 76.5%), while 49 (11.9%) were diagnosed with gestational diabetes, and 33 (8.0%) had single high glucose values. Reactive hypoglycemia was de-tected in only 15 patients (3.6%). The mean age of the women in the reactive hypoglycemia group was significantly lower than that of the women in the gestational diabetes and single high glucose value groups (26.4 ± 4.4 years, 31.4 ± 5.4 years, and 31.8 ± 4.3 years, respectively; p < 0.05). The newborns of the women in the reactive hypoglycemia group had higher rates of APGAR scores < 7, increased admission to the neonatal intensive care unit (NICU), and lower birth weights compared with the other groups (p < 0.001, p < 0.001, and p = 0.009, respectively).

CONCLUSION

Reactive hypoglycemia during the 3 h 100 g OGTT is significantly associated with low APGAR scores, low birth weights, and prenatal admission to the NICU. Therefore, pregnant women who develop hypoglycemia during the 100 g OGTT performed at 24-28 weeks of gestation should receive attentive follow-up care to decrease the possibility of adverse perinatal outcomes.

摘要

目的

确定在100克口服葡萄糖耐量试验(OGTT)期间出现反应性低血糖的孕妇是否有不良妊娠结局风险增加的情况。

材料与方法

我们回顾性分析了2012年1月至2014年12月期间在我院进行妊娠24 - 28周3小时OGTT并分娩的413名妇女的围产期数据。

结果

根据OGTT结果,大多数受试者血糖正常(n = 316,76.5%),49名(11.9%)被诊断为妊娠期糖尿病,33名(8.0%)有单次高血糖值。仅15名患者(3.6%)检测到反应性低血糖。反应性低血糖组妇女的平均年龄显著低于妊娠期糖尿病组和单次高血糖值组妇女(分别为26.4±4.4岁、31.4±5.4岁和31.8±4.3岁;p < 0.05)。与其他组相比,反应性低血糖组妇女的新生儿1分钟阿氏评分<7分、入住新生儿重症监护病房(NICU)的比例增加以及出生体重较低(分别为p < 0.001、p < 0.001和p = 0.009)。

结论

在3小时100克OGTT期间出现的反应性低血糖与低阿氏评分、低出生体重和产前入住NICU显著相关。因此,在妊娠24 - 28周进行100克OGTT时出现低血糖的孕妇应接受密切的随访护理,以降低不良围产期结局的可能性。

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