Parveen Nuzhat, Hassan Sehar-Un-Nisa, Zahra Aqeela, Iqbal Naveed, Batool Asma
Department of Obstetrics and Gynecology, College of Medicine, University of Ha'il, Ha'il-81451, Saudi Arabia.
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il-81451, Saudi Arabia.
Iran J Public Health. 2022 May;51(5):1030-1039. doi: 10.18502/ijph.v51i5.9418.
We assessed risk factors, antenatal and intrapartum complications associated with early-onset Gestational diabetes mellitus (GDM) in comparison with late-onset GDM.
This retrospective study included 161 GDM women having singleton pregnancies, without previous medical disorder and delivered at a tertiary care Hospital in Ha'il City, KSA from Dec 2020 till Jun 2021. Women diagnosed at < 24 weeks of pregnancy were grouped as early-onset GDM (n=71) and those diagnosed at ≥ 24 weeks as late-onset GDM (n=90). Both groups were matched for background variables. Chi-square and binary logistic regression analysis were applied with -value significance at 0.05.
Past history of GDM, macrosomia and stillbirth were significant predictors for early-onset GDM ( value 0.000, 0.002 and 0.040 respectively). Regression analysis showed early-onset GDM significantly increases the risk for recurrent urinary tract infections (AOR 2.35), polyhydramnios (AOR 2.81), reduced fetal movements (AOR 2.13), intrauterine fetal demise (AOR 8.06), macrosomia (AOR 2.16), fetal birth trauma (2.58), low APGAR score at birth (AOR 8.06), and neonatal ICU admissions (AOR 2.65). Rate of preterm birth, hypertensive disorders, labor onset (natural vs. induced) and cesarean section and intrapartum maternal complications were same in both groups.
Early-onset GDM significantly increases certain maternal (recurrent urinary tract infections, polyhydramnios and reduced fetal movements) and fetal complications (intrauterine fetal demise, macrosomia fetal birth trauma, low APGAR score at birth and neonatal ICU admissions). Most of these adverse pregnancy outcomes can be prevented through early registration and screening, close follow up, growth ultrasounds, and provision of efficient emergency and neonatal care services.
我们评估了与早发型妊娠期糖尿病（GDM）相关的危险因素、产前和产时并发症，并与晚发型GDM进行了比较。
这项回顾性研究纳入了161名单胎妊娠的GDM女性，她们既往无疾病史，于2020年12月至2021年6月在沙特阿拉伯哈伊勒市的一家三级医疗医院分娩。妊娠<24周时诊断出的女性被归为早发型GDM组（n = 71），妊娠≥24周时诊断出的女性被归为晚发型GDM组（n = 90）。两组在背景变量方面进行了匹配。应用卡方检验和二元逻辑回归分析，P值显著性水平为0.05。
既往GDM史、巨大儿和死产是早发型GDM的显著预测因素（P值分别为0.000、0.002和0.040）。回归分析显示，早发型GDM显著增加复发性尿路感染（调整后比值比[AOR]为2.35）、羊水过多（AOR为[2.81]）、胎动减少（AOR为2.13）、胎儿宫内死亡（AOR为8.06）、巨大儿（AOR为2.16）、胎儿产伤（2.58）、出生时阿氏评分低（AOR为8.06）以及新生儿入住重症监护病房（AOR为[2.65]）的风险。两组的早产率、高血压疾病、临产（自然临产与引产）、剖宫产和产时母体并发症相同。
早发型GDM显著增加某些母体并发症（复发性尿路感染、羊水过多和胎动减少）和胎儿并发症（胎儿宫内死亡、巨大儿、胎儿产伤、出生时阿氏评分低和新生儿入住重症监护病房）。通过早期登记和筛查密切随访、生长超声检查以及提供有效的急诊和新生儿护理服务，这些不良妊娠结局大多可以预防。
