Etlik Lady Zübeyde Maternity and Women's Health Teaching and Research Hospital, Department of Obstetrics and Gynaecology - Ankara, Turkey.
Etlik Lady Zübeyde Maternity and Women's Health Teaching and Research Hospital, Department of Neonatology - Ankara, Turkey.
Rev Assoc Med Bras (1992). 2024 Jun 17;70(6):e20231390. doi: 10.1590/1806-9282.20231390. eCollection 2024.
The aim of this study was to compare pregnancy outcomes of patients with polyhydramnios due to late-onset gestational diabetes mellitus and patients with isolated polyhydramnios.
Of the women who fully participated in prenatal examinations at Etlik Lady Zübeyde Hospital between January 1, 2018, and December 31, 2019, women with polyhydramnios of nonfetal-placental origin manifesting in the third trimester were retrospectively reviewed. Women with normal 75-g oral glucose tolerance test results between 24 and 28 weeks gestation who met the inclusion criteria were enrolled in the study and divided into two groups based on the results of rescreening with the 75-g oral glucose tolerance test for polyhydramnios in the third trimester: women with isolated polyhydramnios (group 1) and women with late-onset polyhydramnios due to gestational diabetes mellitus (group 2).
There were a total of 295 participants, of whom 35 (11.8%) were diagnosed with polyhydramnios due to late-onset gestational diabetes mellitus. There were no differences in the main outcomes. Birthweight and gestational age at birth were identified as independent risk factors for predicting composite maternal outcome {[odds ratio (OR)=1.273, 95% confidence interval (CI) 1.063-1.524, p=0.009]} and composite neonatal outcome (OR=0.606, CI 0.494-0.744, p<0.001), respectively.
Polyhydramnios in late pregnancy without evidence of pregnancy-related causes leading to polyhydramnios may be a sign of late-onset gestational diabetes mellitus in women with a normal prior oral glucose tolerance test. As pregnancy outcomes and management were indifferent, it does not seem necessary or useful to diagnose whether or not late-onset gestational diabetes mellitus is present.
本研究旨在比较因晚发型妊娠期糖尿病和单纯羊水过多导致的羊水过多患者的妊娠结局。
本研究回顾性分析了 2018 年 1 月 1 日至 2019 年 12 月 31 日期间在埃特利克夫人祖拜德医院（Etlik Lady Zübeyde Hospital）全面接受产前检查的孕妇，这些孕妇存在非胎儿胎盘来源的晚期羊水过多，且表现为孕晚期。符合纳入标准的孕妇于孕 24-28 周行 75g 口服葡萄糖耐量试验（OGTT）正常，于孕晚期行 75g OGTT 筛查发现羊水过多者，根据筛查结果将其分为两组：单纯羊水过多组（1 组）和晚发型妊娠期糖尿病导致的羊水过多组（2 组）。
共纳入 295 例孕妇，其中 35 例（11.8%）诊断为晚发型妊娠期糖尿病导致的羊水过多。主要结局无差异。出生体重和出生时的胎龄被确定为预测复合母体结局（优势比[OR]为 1.273，95%置信区间[CI]为 1.063-1.524，p=0.009）和复合新生儿结局（OR=0.606，CI 为 0.494-0.744，p<0.001）的独立危险因素。
孕晚期无妊娠相关病因导致的羊水过多可能是既往 75g OGTT 正常孕妇发生晚发型妊娠期糖尿病的征象。由于妊娠结局和处理方式无差异，因此诊断是否存在晚发型妊娠期糖尿病似乎没有必要或没有意义。
