Ministry of Health, Vaoila Hospital, Nuku'alofa, Tongatapu, Tonga.
Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Campbelltown, 2560, NSW, Australia.
BMC Pregnancy Childbirth. 2020 Feb 28;20(1):133. doi: 10.1186/s12884-020-2821-6.
Gestational diabetes mellitus (GDM) in Fiji is a serious public health issue. However, there are no recent studies on GDM among pregnant women in Fiji. The aim of this study was to examine prevalence of, and sociodemographic factors associated with adverse neonatal outcomes among Fijian women with GDM.
We used cross-sectional data of 255 pregnant women with GDM who gave birth to singleton infants at Colonial War Memorial Hospital (CWMH) in Suva city. Women underwent testing for GDM during antenatal clinic visits and were diagnosed using modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Multivariable logistic regression analysis was used to investigate factors associated with neonatal outcomes.
Women with a previous baby weighing > 4 kg were 6.08 times more likely to experience neonatal macrosomia (Adjusted odds ratio (AOR) = 6.08; 95%CI: 2.46, 15.01). Compared to unmarried women, the odds of macrosomia among married women reduced by 71% (AOR = 0.29; 95%CI: 0.11, 0.77). Compared with delivery before 38 weeks of gestation, the infants of women who delivered between 38 and 41 weeks of gestation were 62 and 86% less likely to experience neonatal hypoglycaemia and Apgar score < 7 at 5 mins, respectively. The offspring of women who were overweight and obese had higher odds of neonatal hypoglycaemia. Late booking in gestation (≥28 weeks) was significantly associated with Apgar score < 7 at 5 min (AOR = 7.87; 95%CI: 1.11, 55.75). Maternal pre-eclampsia/pregnancy induced hypertension was another factor associated with low Apgar score in infants.
The study found high rates of adverse neonatal outcomes among off springs of Fijian women with GDM and showed that interventions targeting pregnant women who are overweight, had a previous baby weighing > 4 kg, had pre-eclampsia, delivered before 38 weeks of gestation, and those who booked later than 13 weeks in gestation, are needed to improve pregnancy outcomes.
妊娠糖尿病（GDM）在斐济是一个严重的公共卫生问题。然而，目前尚无关于斐济孕妇 GDM 的近期研究。本研究旨在探讨 GDM 孕妇不良新生儿结局的发生率及相关社会人口学因素。
我们使用了 255 名在苏瓦市殖民战争纪念医院（CWMH）分娩单胎婴儿的 GDM 孕妇的横断面数据。孕妇在产前检查期间进行 GDM 检测，并采用改良的国际糖尿病与妊娠研究组（IADPSG）标准进行诊断。采用多变量逻辑回归分析来研究与新生儿结局相关的因素。
前一胎体重>4kg 的孕妇发生新生儿巨大儿的可能性是 6.08 倍（调整后的优势比（AOR）=6.08；95%CI：2.46，15.01）。与未婚女性相比，已婚女性发生巨大儿的可能性降低了 71%（AOR=0.29；95%CI：0.11，0.77）。与 38 周前分娩相比，38 至 41 周分娩的孕妇的新生儿低血糖和 5 分钟时 Apgar 评分<7 的发生率分别降低了 62%和 86%。超重和肥胖的孕妇所生婴儿发生新生儿低血糖的几率较高。妊娠晚期（≥28 周）登记显著与 5 分钟时 Apgar 评分<7 相关（AOR=7.87；95%CI：1.11，55.75）。孕妇子痫前期/妊娠高血压也是与婴儿低 Apgar 评分相关的一个因素。
本研究发现，斐济 GDM 孕妇的新生儿不良结局发生率较高，表明需要针对超重、前一胎体重>4kg、子痫前期、妊娠 38 周前分娩以及妊娠 13 周后才登记的孕妇进行干预，以改善妊娠结局。
