Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar E Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
Department of Nutrition, Centro Hospitalar E Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
Acta Diabetol. 2021 Sep;58(9):1209-1215. doi: 10.1007/s00592-021-01714-w. Epub 2021 Apr 15.
To clarify whether mild first trimester hyperglycaemia (characteristic of early-onset GDM) is associated with higher incidence of congenital malformations and other adverse fetomaternal outcomes compared to women with second trimester hyperglycaemia (later-onset GDM).
We analyzed the Portuguese National GDM database, containing data collected between 2011 and 2017. Two study groups were defined: Group 1-Women with GDM diagnosed during the first trimester (with fasting glycemia ≥ 92 and < 126 mg/dL); Group 2-Women with GDM diagnosed after the first 12 weeks of gestation, with either fasting glycemia or oral glucose tolerance test, according to the International Association of Pregnancy and Diabetes Study Group criteria. The fetomaternal characteristics of each group were compared.
A total of 18.518 pregnant women diagnosed with GDM were included which 34.4% of them belonged to Group 1. Pregnant women from this group were significantly younger and had a higher median BMI than the women from the other group. Overall, there was no significant differences in maternal morbidity parameters between groups. Non-evolutive pregnancies were significantly more frequent along the present gestation in the group 1 (1.1% vs. 0.1%, p < 0.001), as was fetal death (0.6% vs. 0.2%, p < 0.001). Congenital malformations did not differ significantly between groups (3.2% vs. 2.8%, p = 0.155).
The mild near conceptional hyperglycaemic state characteristic of an early-onset GDM seems to be associated with an increased prevalence of non-evolutive pregnancies and foetal deaths when compared to later-onset GDM.
明确早发型妊娠期糖尿病（即起始于妊娠早期的高血糖）患者的轻度早期妊娠高血糖与中孕期高血糖（即迟发型妊娠期糖尿病）患者相比，是否会增加先天畸形及其他不良母婴结局的发生风险。
我们分析了葡萄牙国家妊娠期糖尿病数据库的数据，该数据库包含了 2011 年至 2017 年期间收集的数据。根据诊断时间将患者分为两组：早发型组，患者在妊娠早期（空腹血糖≥92mg/dL 且<126mg/dL）诊断为妊娠期糖尿病；中晚发型组，患者在妊娠 12 周后，根据国际妊娠合并糖尿病研究组织的标准，通过空腹血糖或口服葡萄糖耐量试验诊断为妊娠期糖尿病。比较两组的母婴特征。
共纳入 18518 例诊断为妊娠期糖尿病的孕妇，其中 34.4%的患者属于早发型组。早发型组孕妇明显更年轻，且中位 BMI 更高。总体而言，两组间产妇发病率参数无显著差异。早发型组非进展性妊娠的比例明显更高（1.1% vs. 0.1%，p<0.001），胎儿死亡比例也更高（0.6% vs. 0.2%，p<0.001）。两组间先天畸形的发生率无显著差异（3.2% vs. 2.8%，p=0.155）。
早发型妊娠期糖尿病患者妊娠早期轻度临近受孕的高血糖状态与迟发型妊娠期糖尿病患者相比，似乎与非进展性妊娠和胎儿死亡的发生率增加相关。
