Department of Perinatology, I Division of Gynecology and Obstetrics, Medical University of Lodz, Poland.
Department of Perinatology, Medical University of Lodz, Poland.
J Mother Child. 2024 Oct 23;28(1):87-93. doi: 10.34763/jmotherandchild.20242801.d-24-00004. eCollection 2024 Feb 1.
Despite clear diagnostic criteria for hyperglycaemia first detected in pregnancy, many pregnant women do not have the proper diagnosis. The following paper analyses the course of the perinatal period in pregnant women with undetected hyperglycaemia and their newborns.
Medical data of patients hospitalized in the Department of Perinatology between 2020 and 2022 was verified: 1st group: 40 patients with undetected hyperglycaemia, 2nd group: 40 with the diagnosis of gestational diabetes during pregnancy and adequate therapeutic management. The course of the perinatal period, abnormalities in the oral glucose tolerance test (OGTT) and the compliance with recommended postpartum tests were analysed.
There were significant differences in the newborn weights (p=0.039) - in the 1st group 15% large for gestational age (LGA) vs. 0% in the 2nd, and the occurrence of neonatal hyperbilirubinemia requiring phototherapy (p=0.007) - 22.5% in the 1 group vs. 2.5% in the 2. The most common mistake in the OGTT was evaluation of fasting plasma glucose. In the 1 group, no effect on incidence of hypertensive disorders, time or the route of delivery was observed. 75% from the 1 group and 36% from the 2 did not perform postpartum OGTT (p=0.003).
Hyperglycaemia in pregnancy is often undetected, which has a negative impact, especially on the neonates. In our study, LGA and hyperbilirubinaemia were significantly more common in neonates of mothers with undetected hyperglycaemia. These women had significantly more careless attitude to the postpartum diagnostic, which may influence future health and course of subsequent pregnancies. New and more effective methods of educating practitioners need to be implemented.
尽管有明确的妊娠期间首次发现高血糖的诊断标准，但许多孕妇并未得到正确诊断。本文分析了未被检出的高血糖孕妇及其新生儿的围产期过程。
验证了 2020 年至 2022 年期间在围产医学科住院的患者的医疗数据：第 1 组：40 例未被检出的高血糖患者；第 2 组：40 例在怀孕期间被诊断为妊娠糖尿病且接受了适当治疗的患者。分析了围产期过程、口服葡萄糖耐量试验（OGTT）异常和对推荐的产后检查的依从性。
新生儿体重存在显著差异（p=0.039）-第 1 组 15%为巨大儿（LGA），而第 2 组为 0%；新生儿高胆红素血症需要光疗的发生率（p=0.007）-第 1 组为 22.5%，第 2 组为 2.5%。OGTT 最常见的错误是评估空腹血糖。在第 1 组中，未观察到对高血压疾病的发生率、分娩时间或分娩方式产生影响。第 1 组中有 75%和第 2 组中有 36%的患者未进行产后 OGTT（p=0.003）。
妊娠期间的高血糖常常未被检出，这对新生儿有负面影响。在我们的研究中，未被检出的高血糖孕妇的新生儿中 LGA 和高胆红素血症更为常见。这些女性对产后诊断的态度明显更为粗心，这可能会影响未来的健康和随后妊娠的过程。需要实施新的、更有效的教育医生的方法。
