Thomakos Petros, Kepaptsoglou Olga, Korantzis Asteris, Trouva Anastasia, Sklavounos Ioannis, Trouvas Dimitris, Taraoune Nadia, Barreto Carol, Zoupas Christos Sp
Diabetes Center and Clinic, Hygeia General Hospital, 4 Erythrou Stavrou, 151 23 Marousi, Athens, Greece.
IASO Maternity Hospital, 37-39 Kifisias Avenue, 151 23 Marousi, Athens, Greece.
J Diabetes Complications. 2021 Jun;35(6):107914. doi: 10.1016/j.jdiacomp.2021.107914. Epub 2021 Mar 20.
In Vitro Fertilization (IVF) is increasingly becoming a necessary mode of reproduction. This high risk group is prone to Gestational Diabetes Mellitus (GDM) which further exposes these pregnancies to an increased risk of adverse outcomes. In light of the limited data in the current literature, further investigation is needed regarding the time of GDM diagnosis in IVF pregnancies as well as the outcome of IVF pregnancies complicated by GDM.
In this three center pilot cross sectional study, the data of 101 singleton IVF pregnancies complicated by GDM were analyzed. Prompt GDM diagnosis in IVF pregnancies was accomplished by self-blood glucose monitoring (SMBG) from the first antenatal visit and confirmed by an OGTT. To evaluate pregnancy outcome, maternal and fetal complications in the 101 GDM IVF group was compared to 101 IVF as well as 101 spontaneous conceptions (SC). The three groups were matched by age. The effect of demographic and glycemic parameters on the outcome of GDM IVF pregnancies was investigated.
GDM diagnosis was made before the 24th week in 37.6% of the GDM IVF group. The week of delivery was earlier for the GDM IVF group (37 ± 1.7) relative to the IVF (37.9 ± 0.9, p < 0.001) and the SC group (38.1 ± 0.8, p < 0.001). GDM IVF pregnancies exhibited greater preeclampsia rates and 84.8% underwent caesarian section. No significant difference regarding LGA and SGA birth weights was found. Complications of GDM IVF pregnancies were associated with the 1-h postprandial BG (r = 0.267, p = 0.007).
GDM screening in IVF pregnancies may be considered earlier than the 24th week. IVF pregnancies affected by GDM are prone to increased maternal and fetal complications which are associated with 1-h postprandial BG.
体外受精（IVF）正日益成为一种必要的生殖方式。这一高危群体易患妊娠期糖尿病（GDM），这进一步使这些妊娠面临不良结局风险增加的情况。鉴于当前文献中的数据有限，需要对IVF妊娠中GDM的诊断时间以及合并GDM的IVF妊娠结局进行进一步研究。
在这项三中心试点横断面研究中，分析了101例单胎IVF妊娠合并GDM的数据。通过从首次产前检查开始的自我血糖监测（SMBG）实现IVF妊娠中GDM的及时诊断，并通过口服葡萄糖耐量试验（OGTT）进行确认。为评估妊娠结局，将101例GDM IVF组的母婴并发症与101例IVF以及101例自然受孕（SC）进行比较。三组按年龄匹配。研究了人口统计学和血糖参数对GDM IVF妊娠结局的影响。
GDM IVF组中37.6%在孕24周前诊断出GDM。GDM IVF组的分娩孕周（37±1.7）早于IVF组（37.9±0.9，p<0.001）和SC组（38.1±0.8，p<0.001）。GDM IVF妊娠的子痫前期发生率更高，84.8%接受了剖宫产。在大于胎龄儿（LGA）和小于胎龄儿（SGA）出生体重方面未发现显著差异。GDM IVF妊娠的并发症与餐后1小时血糖（r=0.267，p=0.007）相关。
IVF妊娠中的GDM筛查可考虑在孕24周前进行。受GDM影响的IVF妊娠易出现母婴并发症增加，且与餐后1小时血糖相关。
