与妊娠期糖尿病发生相关的妊娠结局：一项队列研究。
Gestational Outcomes Related to the Occurrence of Gestational Diabetes Mellitus: A Cohort Study.
作者信息
Souza Stork Samara, Meurer Souza Claudia, Somariva Prophiro Josiane, Brownell Elizabeth Ann, Pinto Moehlecke Iser Betine
机构信息
Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão 88704-900, Brazil.
School of Nursing, University of Texas Health, San Antonio, TX 78229, USA.
出版信息
Healthcare (Basel). 2024 Sep 24;12(19):1905. doi: 10.3390/healthcare12191905.
BACKGROUND
Gestational diabetes mellitus (GDM) is the main cause of hyperglycemia in pregnancy and is related to complications throughout the gestational and post-partum period.
OBJECTIVES
To analyze the pregnancy outcomes related to the occurrence of GDM in women and their offspring.
METHODS
Third-trimester pregnant women were interviewed and monitored until childbirth. The diagnosis of GDM, blood glucose ≥ 92 mg/dL, was defined by the criteria of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG).
RESULTS
A total of 138 women participated, and there were 136 births (due to 2 fetal losses); 23 (16.7%) were diagnosed with GDM. The risk of complications during childbirth was higher among pregnant women with GDM (RR 3.40; 95%CI 1.65-7.00), as was the occurrence of cesarean birth (RR 1.9; 95%CI 1.46-2.59). The occurrence of preterm birth did not show a significant difference between GDM/non-GDM groups. There was a non-significant association in adjusted analyses of macrosomia (birth weight ≥ 4000 g) among newborns born to mothers with GDM (RR 1.27; 95%CI 0.67-2.38). For newborns born to pregnant women with GDM, there was a higher risk for the following outcomes: large for gestational age (LGA) (3.29 95%CI 1.62-6.64), low Apgar (4.98 95%CI 2.32-10.69), and birth asphyxia (9.51 95%CI 3.42-26.48).
CONCLUSIONS
The findings reinforce that GDM is an important risk factor for adverse pregnancy outcomes for women and their offspring.
背景
妊娠期糖尿病（GDM）是孕期高血糖的主要原因，与整个孕期及产后并发症相关。
目的
分析与女性及其后代发生GDM相关的妊娠结局。
方法
对孕晚期孕妇进行访谈并监测至分娩。GDM的诊断标准为血糖≥92mg/dL，采用国际糖尿病与妊娠研究组（IADPSG）的标准。
结果
共有138名女性参与，分娩136例（因2例胎儿丢失）；23例（16.7%）被诊断为GDM。GDM孕妇分娩期间并发症风险更高（RR 3.40；95%CI 1.65 - 7.00），剖宫产发生率也更高（RR 1.9；95%CI 1.46 - 2.59）。早产发生率在GDM/非GDM组之间无显著差异。在对GDM母亲所生新生儿巨大儿（出生体重≥4000g）的校正分析中，存在非显著关联（RR 1.27；95%CI 0.67 - 2.38）。对于GDM孕妇所生新生儿，以下结局风险更高：大于胎龄儿（LGA）（3.29 95%CI 1.62 - 6.64）、低阿氏评分（4.98 95%CI 2.32 - 10.69）和出生窒息（9.51 95%CI 3.42 - 26.48）。
结论
研究结果进一步证实，GDM是女性及其后代不良妊娠结局的重要危险因素。
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