From the Department of Medicine, Faculty of Medicine- Rabigh, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi Med J. 2023 Jul;44(7):703-710. doi: 10.15537/smj.2023.44.7.20230193.
To contribute to this discussion by comparing the complications associated with early-diagnosed versus (vs.) late-diagnosed gestational diabetes mellitus (GDM) for mothers and infants in order to provide baseline data that might guide future changes in the current recommendations for screening.
The study compares the risk factors and complications for early- vs. late-diagnosed GDM in a cohort from Saudi Arabia. Prenatal, perinatal, postpartum, and neonatal variables were compared between the early vs. late-diagnosed GDM groups using information gathered from the patient's hospital records.
Significant predictors of early-diagnosed GDM included pregestational BMI and GDM history. Additionally, early diagnosis of GDM was linked to a higher incidence of pre-eclampsia and intrauterine fetal death. Women with early-diagnosed GDM also required more glycemic control interventions, like administering insulin and metformin and controlling their diet. The fetal birth weight and postpartum BMI were significantly higher in the early onset GDM group. The need for insulin and pre-eclampsia were significant factors linked to an early diagnosis of GDM, according to a logistic regression analysis.
Therefore, the current findings emphasize the need for early screening in pregnant women with high pregestational BMI and a history of GDM and show that those with early-onset GDM more likely to need insulin therapy and be at a higher risk of developing pre-eclampsia.
通过比较早发型和晚发型妊娠期糖尿病(GDM)母亲和婴儿的并发症,为当前筛查建议的未来变化提供基线数据,从而为这一讨论做出贡献。
本研究通过来自沙特阿拉伯的队列比较了早发型和晚发型 GDM 的风险因素和并发症。使用从患者的医院记录中收集的信息,比较了早发型和晚发型 GDM 组之间的产前、围产期、产后和新生儿变量。
早发型 GDM 的显著预测因素包括孕前 BMI 和 GDM 病史。此外,GDM 的早期诊断与子痫前期和宫内胎儿死亡的发生率较高有关。早发型 GDM 的女性还需要更多的血糖控制干预,如使用胰岛素和二甲双胍以及控制饮食。早发型 GDM 组的胎儿出生体重和产后 BMI 明显更高。逻辑回归分析显示,胰岛素和子痫前期是与早发型 GDM 相关的显著因素。
因此,目前的研究结果强调了对孕前 BMI 较高和有 GDM 病史的孕妇进行早期筛查的必要性,并表明早发型 GDM 更可能需要胰岛素治疗,发生子痫前期的风险更高。