Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Diabet Med. 2023 Jan;40(1):e14950. doi: 10.1111/dme.14950. Epub 2022 Sep 20.
There is limited information regarding the association between missed appointments and neonatal outcomes for diabetes in pregnancy.
This retrospective live birth cohort included pregnant women with Type 1 or 2 diabetes who attended specialized clinics from 2008 to 2020. The association between at least one missed antenatal diabetes appointments and outcomes were assessed using logistic regression and reported as adjusted odds ratios (aOR) (95% confidence interval). Mediation analyses were conducted to examine if above target HbA1c mediated these relationships.
The cohort included 407 and 902 women with Type 1 and 2 diabetes, respectively, of whom 25.1% and 34.5% missed at least one appointment. Women with Type 1 diabetes who missed an appointment were more likely to have a caesarean section (aOR 1.95 [1.15, 3.31]) and their babies more likely to be admitted to the neonatal intensive care unit (aOR 2.25 [1.35, 3.75]). Women with Type 2 diabetes who missed an appointment were more likely to have a large-for-gestational-age infant (aOR 1.61 [1.13, 2.28]), and an extreme large-for-gestational-age infant (aOR 1.69 [1.02, 2.81]) compared with women who did not miss appointments. Above target HbA1c mediated the relationship between missed appointments and caesarean delivery in Type 1 diabetes and large-for-gestational age and extreme large-for-gestational age in Type 2 diabetes.
In individuals with Type 1 and 2 diabetes, there are differences in neonatal outcomes between those who missed an appointment compared to those who did not. It remains unclear if missed diabetes appointments are causative or a marker of other health behaviours or risk factors leading to neonatal morbidity.
关于妊娠糖尿病中错过预约与新生儿结局之间的关系，相关信息有限。
本回顾性活产队列纳入了 2008 年至 2020 年期间在专科诊所就诊的 1 型或 2 型糖尿病孕妇。使用逻辑回归评估至少一次错过产前糖尿病预约与结局之间的关联，并以校正优势比（aOR）（95%置信区间）报告。进行中介分析以检验高于目标的 HbA1c 是否介导这些关系。
该队列分别纳入了 407 名和 902 名 1 型和 2 型糖尿病女性，其中分别有 25.1%和 34.5%的女性至少错过了一次预约。错过预约的 1 型糖尿病女性更有可能行剖宫产术（aOR 1.95 [1.15, 3.31]），其婴儿更有可能入住新生儿重症监护病房（aOR 2.25 [1.35, 3.75]）。错过预约的 2 型糖尿病女性更有可能分娩出巨大儿（aOR 1.61 [1.13, 2.28]）和特大儿（aOR 1.69 [1.02, 2.81]）。高于目标的 HbA1c 介导了 1 型糖尿病中错过预约与剖宫产、2 型糖尿病中巨大儿和特大儿之间的关系。
在 1 型和 2 型糖尿病个体中，与未错过预约的个体相比，错过预约的个体新生儿结局存在差异。尚不清楚错过糖尿病预约是否是导致新生儿发病率的原因，还是其他健康行为或风险因素的标志物。
