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妊娠期糖尿病对母婴不良结局风险的影响:埃塞俄比亚西北部的一项前瞻性队列研究。

Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia.

机构信息

Department of Obstetrics and Gynecology, Pan African University Life and Earth Sciences Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2020 Feb 3;20(1):73. doi: 10.1186/s12884-020-2759-8.

Abstract

BACKGROUND

Gestational diabetes mellitus is a leading medical condition woman encounter during pregnancy with serious short- and long-term consequences for maternal morbidity. However, limited evidence was available on potential impacts of gestational diabetes mellitus using updated international diagnostic criteria on adverse maternal outcomes. Therefore, this study aimed to assess the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes in Northwest Ethiopia.

METHODS

A prospective cohort study was conducted among pregnant women followed from pregnancy to delivery. Gestational diabetes mellitus status was determined by using a two-hour 75 g oral glucose tolerance test and based on updated international diagnostic criteria. Multivariable log-binomial model was used to examine the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes.

RESULTS

A total of 694 women completed the follow-up and included in the analysis. Women with gestational diabetes mellitus had a higher risk of composite adverse maternal outcome (ARR=1.58, 95% CI: 1.22, 2.04), caesarean delivery (ARR=1.67; 95%: 1.15, 2.44), pregnancy induced hypertension (ARR= 3.32; 95%: 1.55, 7.11), premature rupture of membranes (ARR= 1.83; 95%: 1.02, 3.27), antepartum hemorrhage (ARR= 2.10; 95%: 1.11, 3.98) and postpartum hemorrhage (ARR= 4.85; 95%:2.28, 10.30) compared to women without gestational diabetes mellitus.

CONCLUSIONS

Gestational diabetes mellitus increased the risk of adverse maternal outcomes. This implies that maternal care and intervention strategies relating to women with gestational diabetes mellitus should be strengthened.

摘要

背景

妊娠糖尿病是女性在怀孕期间面临的主要医疗问题,对产妇的短期和长期健康都有严重影响。然而,使用最新的国际诊断标准评估妊娠糖尿病对不良母婴结局的潜在影响的证据有限。因此,本研究旨在评估妊娠糖尿病对埃塞俄比亚西北部不良母婴结局风险的影响。

方法

对从妊娠到分娩期间接受随访的孕妇进行前瞻性队列研究。通过两小时 75 克口服葡萄糖耐量试验,并基于最新的国际诊断标准,确定妊娠糖尿病的状态。采用多变量对数二项式模型来检验妊娠糖尿病对不良母婴结局风险的影响。

结果

共有 694 名妇女完成了随访并纳入了分析。患有妊娠糖尿病的妇女发生复合不良母婴结局的风险更高(ARR=1.58,95%CI:1.22,2.04)、剖宫产(ARR=1.67;95%:1.15,2.44)、妊娠高血压(ARR=3.32;95%:1.55,7.11)、胎膜早破(ARR=1.83;95%:1.02,3.27)、产前出血(ARR=2.10;95%:1.11,3.98)和产后出血(ARR=4.85;95%:2.28,10.30)的风险高于没有妊娠糖尿病的妇女。

结论

妊娠糖尿病增加了不良母婴结局的风险。这意味着应该加强针对患有妊娠糖尿病的产妇的护理和干预策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e36/6998275/c0850ee59404/12884_2020_2759_Fig1_HTML.jpg

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