Departamento de Obstetricia e Ginecologia da Faculdade de Medicina da, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil.
Divisao de Clinica Obstetrica do Hospital das Clínicas da Faculdade de Medicina da, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil.
Int J Environ Res Public Health. 2022 Oct 22;19(21):13719. doi: 10.3390/ijerph192113719.
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with GDM presents data from 1891 patients (1004 in the eGDM and 887 in the late GDM group). Student's t-test, chi-squared or Fisher's exact test and the Bonferroni test for post hoc analysis were used to compare the groups. Women with eGDM had higher pre-pregnancy BMI, more frequent family history of DM, more frequent history of previous GDM, and were more likely to have chronic hypertension. They were more likely to deliver by cesarean section and to present an abnormal puerperal OGTT. Even though they received earlier treatment and required insulin more frequently, there was no difference in neonatal outcomes. Diagnosing and treating GDM is necessary to reduce complications and adverse outcomes, but it is still a challenge. We believe that women with eGDM should be treated and closely monitored, even though this may increase healthcare-related costs.
妊娠期糖尿病（GDM）是妊娠期间最常见的并发症之一。它可以通过在妊娠早期进行空腹血糖（FPG）检测（eGDM）或 75g 口服葡萄糖耐量试验（OGTT）（晚 GDM）来诊断。这项回顾性队列研究纳入了 1891 名 GDM 患者的数据（eGDM 组 1004 例，晚 GDM 组 887 例）。使用学生 t 检验、卡方检验或 Fisher 确切检验和事后 Bonferroni 检验比较组间差异。eGDM 组的孕妇孕前 BMI 更高，糖尿病家族史更常见，既往 GDM 史更常见，且更易发生慢性高血压。她们更可能行剖宫产分娩，且产褥期 OGTT 异常。尽管 eGDM 组接受了更早的治疗且更频繁地需要胰岛素，但新生儿结局并无差异。诊断和治疗 GDM 对于减少并发症和不良结局是必要的，但这仍然是一个挑战。我们认为，即使这可能会增加医疗相关费用，eGDM 患者也应接受治疗并密切监测。
