Huang Shuyao, Guo Yanni, Xu Xia, Jiang Lingling, Yan Jianying
Fujian Provincial Maternity and Children's Hospital, No. 18, Daoshan Road, Gulou District, Fuzhou, Fujian Province, 350001, China.
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
BMC Pregnancy Childbirth. 2024 Oct 1;24(1):631. doi: 10.1186/s12884-024-06810-7.
To delineate the clinical characteristics of preterm birth (PTB) in the context of gestational diabetes mellitus (GDM).
A retrospective cohort study was conducted, including 14,314 pregnant women with GDM who delivered at Fujian Provincial Maternity and Children's Hospital from January 1, 2018, to December 31, 2021. PTB was stratified into late PTB (34-36 weeks of gestation) and early PTB (< 34 weeks) and pregnancy complications were analyzed.
Compared to the term birth (TB) cohort, a higher prevalence of premature rupture of membranes, hypertensive diseases of pregnancy (HDP), intrahepatic cholestasis of pregnancy (ICP), anemia and cervical insufficiency was observed in the PTB cohort. Notably, early PTB increased the incidence of HDP, ICP, anemia and cervical insufficiency compared to late PTB. In the early stages of pregnancy, early PTB was characterized by elevated triglyceride (TG) levels and decreased high-density lipoprotein cholesterol (HDL-C) levels compared to late PTB. In the late pregnancy stages, early PTB was associated with increased white blood cell (WBC) and neutrophil counts. No disparities were observed in 75 g oral glucose tolerance test (OGTT) between early and late PTB.
Enhanced surveillance and management of GDM, particularly in the presence of HDP, ICP and anemia, are imperative to mitigate the risk of PTB. The lipid profile may serve as a predictive tool for early PTB in the early stages of pregnancy, warranting further studies.
明确妊娠期糖尿病（GDM）背景下早产（PTB）的临床特征。
进行一项回顾性队列研究，纳入2018年1月1日至2021年12月31日在福建省妇幼保健院分娩的14314例GDM孕妇。将早产分为晚期早产（妊娠34 - 36周）和早期早产（<34周），并分析妊娠并发症。
与足月产（TB）队列相比，早产队列中胎膜早破、妊娠高血压疾病（HDP）、妊娠期肝内胆汁淤积症（ICP）、贫血和宫颈机能不全的患病率更高。值得注意的是，与晚期早产相比，早期早产增加了HDP、ICP、贫血和宫颈机能不全的发生率。在妊娠早期，与晚期早产相比，早期早产的特征是甘油三酯（TG）水平升高和高密度脂蛋白胆固醇（HDL - C）水平降低。在妊娠晚期，早期早产与白细胞（WBC）和中性粒细胞计数增加有关。早期早产和晚期早产在75g口服葡萄糖耐量试验（OGTT）方面未观察到差异。
加强GDM的监测和管理，尤其是在存在HDP、ICP和贫血的情况下，对于降低早产风险至关重要。血脂谱可能作为妊娠早期早期早产的预测工具，值得进一步研究。
