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单家医疗机构中妊娠糖尿病的产科和新生儿发病率风险:一项回顾性、观察性研究。

Risk of obstetric and neonatal morbidity in gestational diabetes in a single institution: A retrospective, observational study.

机构信息

Department of Obstetrics and Gynecology, Yonsei University Institute of Women's Life Medical Science, Seoul, South Korea.

Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.

出版信息

Medicine (Baltimore). 2022 Sep 30;101(39):e30777. doi: 10.1097/MD.0000000000030777.

Abstract

Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance with onset or first recognition occurring during pregnancy and GDM could be risk factor for various maternal fetal complications. This study aimed to investigate risks of maternal and neonatal outcomes according to GDM and normal glucose tolerance. This retrospective, observational study included singleton pregnant women who had received a 50-g oral glucose challenge test in 2nd trimester of gestation and gave birth at National Health Insurance Service Ilsan Hospital. Maternal and neonatal complications were compared between GDM and non-GDM groups. Among the 682 women, 56 were diagnosed with GDM and 626 were non-GDM group. Maternal age was older and prepregnant body mass index was higher in GDM. The rate of cesarean delivery, preeclampsia, and transfusion was similar; however, the incidence of preterm birth was higher in GDM. Multivariate analysis, however, showed that GDM was independent risk factor only for preterm birth in <37 weeks (adjusted odds ratio, 2.25; 95% confidence interval, 1.16-4.36). Regarding neonatal morbidities, APGAR score <7 at 5 minutes and the rate of macrosomia were similar; however, the rates of neonatal intensive care unit (NICU) admission, large for gestational age (LGA), and intubation were higher in GDM. Multivariate analysis, however, showed that GDM was not independent risk factor for LGA, NICU admission, and intubation rate. Compared with the non-GDM group, GDM was associated with an increased likelihood of preterm birth <37 weeks, however, did not increase cesarean delivery, postpartum hemorrhage, LGA, and NICU admission rate. This study showed that the majority of women with GDM delivered with similar maternal and neonatal outcomes in non-GDM women.

摘要

妊娠期糖尿病(GDM)是指一种碳水化合物不耐受症,其发病或首次确诊于妊娠期间,且 GDM 可能是各种母婴并发症的危险因素。本研究旨在探讨 GDM 和正常葡萄糖耐量孕妇及新生儿结局的风险。本回顾性观察性研究纳入了在妊娠中期接受过 50g 口服葡萄糖耐量试验且在国立保健院 Ilsan 医院分娩的单胎孕妇。比较了 GDM 组和非 GDM 组的母婴并发症。在 682 名女性中,56 名被诊断为 GDM,626 名是非 GDM 组。GDM 组的产妇年龄较大,孕前体质量指数较高。剖宫产、子痫前期和输血的发生率相似,但 GDM 组早产率较高。然而,多变量分析显示,GDM 仅是 <37 周早产的独立危险因素(调整后的优势比,2.25;95%置信区间,1.16-4.36)。关于新生儿发病率,5 分钟时 APGAR 评分<7 和巨大儿的发生率相似;然而,GDM 组新生儿重症监护病房(NICU)入住率、大于胎龄儿(LGA)和气管插管率较高。然而,多变量分析显示,GDM 并不是 LGA、NICU 入住和气管插管率的独立危险因素。与非 GDM 组相比,GDM 与 <37 周早产的可能性增加相关,但不增加剖宫产、产后出血、LGA 和 NICU 入住率。本研究表明,大多数 GDM 孕妇的母婴结局与非 GDM 孕妇相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d613/9524864/7d1c4bb0b336/medi-101-e30777-g001.jpg

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