Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2395495. doi: 10.1080/14767058.2024.2395495. Epub 2024 Aug 28.
This study aimed to determine the likelihood of hyperglycemia postpartum in women with gestational diabetes mellitus (GDM) and to identify the predictors.
The retrospective cohort study involved 1 527 GDM patients who delivered at Peking University First Hospital from 1 January 2021, to 31 December 2021. According to the blood glucose level of postpartum oral glucose tolerance test (OGTT), women were divided into a normal glucose tolerance (NGT) group and a hyperglycemia group, and their characteristics and risk factors of hyperglycemia were compared.
The prevalence of hyperglycemia was 33.9% (184/543) at 6-12 weeks postpartum. Compared with the NGT group, the fasting plasma glucose (FPG) of hyperglycemia group increased significantly during pregnancy and postpartum, the OGTT 1h postprandial glucose (PG) and 2hPG increased in the second trimester of pregnancy, the triglyceride (TG) increased in the first trimester of pregnancy and postpartum, the triglyceride glucose (TyG) index increased in the first trimester of pregnancy and postpartum, and the total cholesterol (TCHO) and low density lipoprotein cholesterol (LDL-C) decreased in the second trimester ( < 0.05). Fasting plasma glucose (FPG) in the first trimester [odds ratio (OR) = 3.583, < 0.001], OGTT 2hPG in the second trimester (OR = 1.604, < 0.001), the TyG index in the first trimester (OR = 1.863, = 0.045) and FPG in third trimester (OR = 1.985, = 0.024) were independent risk factors for postpartum hyperglycemia.
Approximately one-third of women with GDM have hyperglycemia 6-12 weeks after delivery. FPG and the TyG index in the first trimester, OGTT 2hPG in the second trimester and FPG in third trimester are risk factors for postpartum hyperglycemia.
本研究旨在确定患有妊娠期糖尿病（GDM）的女性产后发生高血糖的可能性，并确定其预测因素。
本回顾性队列研究纳入了 2021 年 1 月 1 日至 2021 年 12 月 31 日期间在北京大学第一医院分娩的 1527 例 GDM 患者。根据产后口服葡萄糖耐量试验（OGTT）的血糖水平，将女性分为正常糖耐量（NGT）组和高血糖组，比较两组的高血糖特征和危险因素。
产后 6-12 周高血糖的患病率为 33.9%（184/543）。与 NGT 组相比，高血糖组在妊娠和产后期间空腹血糖（FPG）显著升高，妊娠中期 OGTT 1h 餐后血糖（PG）和 2hPG 升高，妊娠早期甘油三酯（TG）和产后 TG 升高，妊娠早期和产后 TyG 指数升高，妊娠中期总胆固醇（TCHO）和低密度脂蛋白胆固醇（LDL-C）降低（ < 0.05）。妊娠早期 FPG（比值比 [OR] = 3.583， < 0.001）、妊娠中期 OGTT 2hPG（OR = 1.604， < 0.001）、妊娠早期 TyG 指数（OR = 1.863， = 0.045）和妊娠晚期 FPG（OR = 1.985， = 0.024）是产后高血糖的独立危险因素。
大约三分之一的 GDM 女性在产后 6-12 周会发生高血糖。妊娠早期的 FPG 和 TyG 指数、妊娠中期的 OGTT 2hPG 和妊娠晚期的 FPG 是产后高血糖的危险因素。
