College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Fujian Maternity and Child Health Hospital, Fuzhou, China.
J Diabetes. 2022 Apr;14(4):282-290. doi: 10.1111/1753-0407.13263. Epub 2022 Apr 3.
Gestational diabetes mellitus (GDM) is glucose intolerance diagnosed during pregnancy. We aimed to explore the different outcomes of women with two consecutive pregnancies with GDM.
This study included 861 women with recurrent GDM who had two consecutive singleton deliveries at Fujian Maternity and Child Health Hospital between May 2012 and September 2020. Data on pregnancy complications and neonatal and delivery outcomes were collected and analyzed.
Among those women with recurrent GDM, there was no difference in pregnancy complications in index pregnancy vs subsequent pregnancy. Our data revealed there was a significantly higher incidence of thyroid disease in the subsequent pregnancies than in the index pregnancy. (6% vs 10%, p = .003)In subsequent pregnancies, the birth weight was greater than that of the index pregnancy (3296.63 ± 16.85 vs 3348.99 ± 16.05, p = .025); and the incidence of large for gestational age (LGA) was higher than that of the index pregnancy (16.3% vs 20.6%, p = .021). More cesarean sections occurred in the subsequent pregnancy. (32.9% vs 6.6%, p = .039). Postpartum hemorrhage, premature birth, and placental abruption were not significantly different between the two pregnancies.
The results suggest the effect of GDM on thyroid dysfunction may be persistent. Recurrent gestational diabetes results in a higher rate of cesarean delivery, incidence of LGA, and neonatal admission to the neonatal intensive care unit (NICU) in subsequent pregnancies. We need to pay attention to the postpartum thyroid function of pregnant women with GDM. Further studies are still needed on recurrent GDM to reduce this occurrence of admission to NICU.
妊娠期糖尿病（GDM）是指在怀孕期间诊断出的葡萄糖不耐受。我们旨在探讨连续两次妊娠患有 GDM 的女性的不同结局。
本研究纳入了 2012 年 5 月至 2020 年 9 月期间在福建妇幼保健院连续两次单胎分娩的 861 例复发性 GDM 妇女。收集并分析了妊娠并发症和新生儿及分娩结局的数据。
在复发性 GDM 妇女中，指数妊娠与后续妊娠的妊娠并发症无差异。我们的数据显示，后续妊娠甲状腺疾病的发生率明显高于指数妊娠（6%比 10%，p=0.003）。在后续妊娠中，出生体重大于指数妊娠（3296.63±16.85 比 3348.99±16.05，p=0.025）；巨大儿（LGA）的发生率高于指数妊娠（16.3%比 20.6%，p=0.021）。后续妊娠中剖宫产的比例更高（32.9%比 6.6%，p=0.039）。产后出血、早产和胎盘早剥在两次妊娠中无显著差异。
结果表明 GDM 对甲状腺功能障碍的影响可能是持续存在的。复发性妊娠期糖尿病导致后续妊娠剖宫产率、LGA 发生率和新生儿入住新生儿重症监护病房（NICU）的比例升高。我们需要关注 GDM 孕妇的产后甲状腺功能。需要进一步研究复发性 GDM 以降低 NICU 入院率。
