Abdullah Saba, Mughal Saba, Samuel Mahwish, Hossain Nazli
Saba Abdullah, MBBS., Postgraduate Resident, Dow University of Health Sciences, Karachi, Pakistan.
Shumaila, MBBS., Postgraduate Resident, Dow University of Health Sciences, Karachi, Pakistan.
Pak J Med Sci. 2023 Mar-Apr;39(2):323-329. doi: 10.12669/pjms.39.2.7332.
To compare maternal and perinatal outcome of Ramadan fasting during pregnancy in women with/without gestational diabetes.
This prospective case-control study was conducted at Department of Obstetrics & Gynecology Unit 1 Ruth PKM Civil Hospital & Dow Medical College and Holy Family Hospital, Karachi during 1 April to 31 July, 2022. In this study normoglycemic pregnant women and those identified as gestational diabetes (n=52) on oral glucose tolerance test, who fasted during Ramadan were included. Women, on diet control or diet plus metformin were included in the study. Study questionnaire included demographic details, days of fasting, self-reported hypoglycemic episodes. Maternal outcomes included preterm birth, pregnancy induced hypertension. Perinatal outcome included hyperbilirubinemia, hypoglycemia, weight of placenta, and apgar score.
Eighty two women were included in the study, gestational diabetes (n=57) and normoglycemic (n=25). Average days of fasting were 16 ±9.0 days (range 5-30). Women with GDM were older (28.6 vs. 26.0 years, p-value=0.034), had raised levels of HbA1c (5.5 vs. 5.1, p-value=0.004), mean FBS (102.8 vs. 84.6 mg/dl, p-value <0.001), mean RBS (135.3 vs. 106.4 mg/dl, p-value <0.001) and had higher BMI at delivery (31.0 vs. 26.6 kg/m, p-value=0.004). HbA1c (p-value=0.016) and head circumference of baby (p-value=0.038) were found lower in the group who fasted for more than 20 days among normoglycemic pregnant women. No other maternal and neonatal outcomes were found to be significantly affected by Ramadan fasting among pregnant women with/without GDM.
Gestational diabetes do not affect maternal and perinatal outcome among pregnant women.
比较患有/未患有妊娠期糖尿病的孕妇在斋月期间禁食对孕产妇及围产期结局的影响。
本前瞻性病例对照研究于2022年4月1日至7月31日在卡拉奇鲁思PKM公民医院及道医学院妇产科1单元以及圣家医院进行。本研究纳入了血糖正常的孕妇以及口服葡萄糖耐量试验确诊为妊娠期糖尿病(n = 52)且在斋月期间禁食的孕妇。纳入了通过饮食控制或饮食加二甲双胍治疗的孕妇。研究问卷包括人口统计学细节、禁食天数、自我报告的低血糖发作情况。孕产妇结局包括早产、妊娠期高血压。围产期结局包括高胆红素血症、低血糖、胎盘重量及阿氏评分。
82名女性纳入研究,其中妊娠期糖尿病患者(n = 57),血糖正常者(n = 25)。平均禁食天数为16±9.0天(范围5 - 30天)。患有妊娠期糖尿病的女性年龄更大(28.6岁对26.0岁,p值 = 0.034),糖化血红蛋白水平更高(5.5对5.1,p值 = 0.004),空腹血糖均值更高(102.8对84.6mg/dl,p值<0.001),随机血糖均值更高(135.3对106.4mg/dl),分娩时体重指数更高(31.0对26.6kg/m²,p值 = 0.004)。在血糖正常的孕妇中,禁食超过20天的组糖化血红蛋白(p值 = 0.016)及婴儿头围(p值 = 0.038)更低。在患有/未患有妊娠期糖尿病的孕妇中,未发现斋月禁食对其他孕产妇及新生儿结局有显著影响。
妊娠期糖尿病不影响孕妇的孕产妇及围产期结局。