Department of Emergency, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Obstetrics and Gynecology, Shanghai Clinical Center for Severe Maternal Rescue, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Diabetes Res Clin Pract. 2020 Mar;161:108085. doi: 10.1016/j.diabres.2020.108085. Epub 2020 Feb 13.
To assess the prevalence and risk of adverse perinatal outcomes in pregnant women with abnormal glucose metabolism.
3269 Chinese pregnant women with singleton delivery were studied, including 787 diagnosed as gestational diabetes mellitus (GDM), 115 pregnancy with diabetes (PWD), and 2367 normal glucose tolerance (NGT). The prevalence and risk of adverse maternal and fetal outcomes were compared and assessed among the three groups, and the related risk factors of the glucose metabolism for adverse pregnancy outcomes were evaluated by binary logistic regression.
Compared to NGT, maternal GDM and PWD faced increased risk of adverse perinatal outcomes such as pregnancy-induced hypertension (odds ratio (OR) 1.78 [95% confidence interval (CI): 1.17-2.72]; 4.31 [95% CI: 2.32-7.98]), low birth weight (OR 1.51 [95% CI: 1.01-2.28]; 4.05 [95% CI: 2.17-7.55]). And PWD group exhibited remarkably higher risk for preterm delivery (OR 2.88 [95% CI: 1.68-4.94]) and stillbirth (OR 7.78 [95% CI: 2.44-24.84]) than other two groups. The increased fasting insulin and glycated hemoglobin A1c were successively independent risk factors for maternal and neonatal adverse outcomes.
Gestational abnormal glucose metabolism is associated with the remarkably increased risk of adverse perinatal outcomes, and PWD has higher risk of adverse perinatal outcomes than GDM.
评估患有异常葡萄糖代谢的孕妇不良围产结局的患病率和风险。
研究了 3269 名单胎分娩的中国孕妇，包括 787 名被诊断为妊娠期糖尿病（GDM）、115 名患有糖尿病的孕妇（PWD）和 2367 名正常糖耐量（NGT）孕妇。比较了三组之间不良母婴结局的患病率和风险，并通过二项逻辑回归评估了葡萄糖代谢对不良妊娠结局的相关危险因素。
与 NGT 相比，GDM 和 PWD 孕妇发生妊娠高血压（比值比 (OR) 1.78 [95%置信区间 (CI)：1.17-2.72]；4.31 [95% CI：2.32-7.98]）和低出生体重（OR 1.51 [95% CI：1.01-2.28]；4.05 [95% CI：2.17-7.55]）等不良围产结局的风险增加。而 PWD 组早产（OR 2.88 [95% CI：1.68-4.94]）和死胎（OR 7.78 [95% CI：2.44-24.84]）的风险明显高于其他两组。空腹胰岛素和糖化血红蛋白 A1c 升高是母婴不良结局的独立危险因素。
妊娠期间异常葡萄糖代谢与不良围产结局的风险显著增加有关，PWD 的不良围产结局风险高于 GDM。
