Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital Izmir, 35170, Turkey.
J Gynecol Obstet Hum Reprod. 2020 Apr;49(4):101703. doi: 10.1016/j.jogoh.2020.101703. Epub 2020 Feb 1.
The aim of this study was to investigate the effects of hypoglycemia measured using 2-h 75-g oral glucose tolerance test (OGTT) on neonatal biometrics (birth weight, head circumference and body length of newborns) and perinatal outcomes.
According to the definition of hypoglycemia by the American Diabetes Association, women with blood glucose levels of ≤70 mg/dL after fasting or at 1 or 2 h after eating measured using on 2-h 75-g OGTT were grouped into a hypoglycemia group. In accordance with the criteria of World Health Organization and the International Association of Diabetes and Pregnancy Study Groups, as per the 2-h 75-g OGTT performed in the second trimester, women with gestational diabetes and were excluded from the study. Also, women meeting the following criteria were excluded from the study: missing records, aged <19 or ≥35 years, multiple pregnancies, delivery before the 24 gestational week, and ≤500-g newborn. Other exclusion criteria included pregnant women with known type 1 and type 2 diabetes mellitus, gestational or essential hypertension, cigarette and/or alcohol abuse, thyroid disease, BMI of <19 and >30, placental abnormalities with variation and/or dysfunction, intrauterine growth restriction, and abnormalities of the umbilical cord.
A total of 625 pregnant women who met the inclusion criteria were included in the study. Hypoglycemia was found in 71 pregnant women according to 2-h 75-g OGTT. The remaining 554 women were grouped into the normoglycemia group. The birth weight, head circumference, and body length of newborns were significantly lower in the hypoglycemia group (p < 0.001, p = 0.004, and p = 0.006, respectively). There was no significant difference between both groups in terms of body mass index, parity, fetal sex, delivery type, and Apgar scores.
Glycemia with blood glucose levels of ≤70 mg/dL measured using 75-g OGTT during pregnancy is associated with lower birth weight, small head circumference, and short body length in newborns compared to the normoglycemic group. Hence, pregnant women who are diagnosed with blood glucose levels of ≤70 mg/dL using 2-h 75-g OGTT should be carefully managed.
本研究旨在探讨使用 2 小时 75 克口服葡萄糖耐量试验（OGTT）测量的低血糖对新生儿生物测量值（新生儿出生体重、头围和身长）和围产期结局的影响。
根据美国糖尿病协会对低血糖的定义，将血糖水平在空腹或进食后 1 或 2 小时后≤70mg/dL 的女性分为低血糖组。根据世界卫生组织和国际妊娠糖尿病研究协会的标准，排除在 2 小时 75 克 OGTT 中患有妊娠期糖尿病的女性。此外，还排除了以下标准的女性：记录缺失、年龄<19 或≥35 岁、多胎妊娠、分娩在 24 孕周前、新生儿体重≤500g。其他排除标准包括患有已知的 1 型和 2 型糖尿病、妊娠或原发性高血压、吸烟和/或酗酒、甲状腺疾病、BMI<19 和>30、胎盘异常伴变异和/或功能障碍、宫内生长受限和脐带异常的孕妇。
共有 625 名符合纳入标准的孕妇纳入本研究。根据 2 小时 75 克 OGTT，71 名孕妇出现低血糖。其余 554 名孕妇被分为正常血糖组。低血糖组新生儿的出生体重、头围和身长明显较低（p<0.001、p=0.004 和 p=0.006）。两组在体重指数、产次、胎儿性别、分娩方式和 Apgar 评分方面无显著差异。
与正常血糖组相比，妊娠期使用 75 克 OGTT 测量血糖水平≤70mg/dL 与新生儿出生体重较低、头围较小和身长较短有关。因此，对于诊断为使用 2 小时 75 克 OGTT 测量血糖水平≤70mg/dL 的孕妇，应谨慎管理。
