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孕早期的妊娠期糖尿病与产后葡萄糖耐量异常相关:来自日本母婴糖尿病与妊娠结局研究的观点

Gestational diabetes in early pregnancy is associated with postpartum glucose intolerance: A perspective from the diabetes and pregnancy outcome for mother and baby study in Japan.

作者信息

Yokoyama Maki, Miyakoshi Kei, Iwama Noriyuki, Yamashita Hiroshi, Yasuhi Ichiro, Kawasaki Maki, Arata Naoko, Sato Shiori, Imura Yuko, Waguri Masako, Kawaguchi Haruna, Masaoka Naoki, Nakajima Yoshiyuki, Hiramatsu Yuji, Sugiyama Takashi

机构信息

Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Ehime, Japan.

Department of Obstetrics and Gynecology, International Catholic Hospital, Tokyo, Japan.

出版信息

J Diabetes Investig. 2025 Mar;16(3):535-542. doi: 10.1111/jdi.14368. Epub 2024 Nov 28.

Abstract

AIMS

To compare perinatal outcomes and postpartum glucose tolerance between women diagnosed with gestational diabetes mellitus (GDM) before 20 weeks of gestation (EGDM) and those diagnosed at or after 24 weeks of gestation (LGDM) in a Japanese population.

MATERIALS AND METHODS

Data were obtained from a prospective GDM registry. Multivariate analysis was conducted to examine the association between the timing of GDM diagnosis (EGDM vs LGDM) and perinatal outcomes (preterm birth, small for gestational age, large for gestational age, pregnancy-induced hypertension, and neonatal hypoglycemia), as well as postpartum glucose intolerance.

RESULTS

A total of 1,275 mother-infant pairs were analyzed for perinatal outcomes. Of these, 924 women underwent postpartum testing for glucose intolerance. No significant differences in perinatal outcomes were observed between the EGDM and LGDM groups, except that overweight/obese women with EGDM had 2.5-fold higher rate of preterm birth than those with LGDM. Postpartum glucose intolerance was 1.5 times more likely in the EGDM group than in the LGDM group.

CONCLUSIONS

Women with EGDM had a significantly higher risk of postpartum glucose intolerance than those with LGDM, despite similar perinatal outcomes between the two groups.

摘要

目的

比较日本人群中妊娠20周前诊断为妊娠期糖尿病(GDM)的女性(早发型GDM,EGDM)和妊娠24周及以后诊断为GDM的女性(晚发型GDM,LGDM)的围产期结局和产后糖耐量。

材料与方法

数据来自前瞻性GDM登记处。进行多变量分析以检验GDM诊断时间(EGDM与LGDM)与围产期结局(早产、小于胎龄儿、大于胎龄儿、妊娠高血压和新生儿低血糖)以及产后糖耐量异常之间的关联。

结果

共分析了1275对母婴的围产期结局。其中,924名女性进行了产后糖耐量检测。EGDM组和LGDM组的围产期结局无显著差异,但早发型GDM的超重/肥胖女性早产率比晚发型GDM者高2.5倍。EGDM组产后糖耐量异常的可能性是LGDM组的1.5倍。

结论

尽管两组围产期结局相似,但早发型GDM女性产后糖耐量异常的风险显著高于晚发型GDM女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cfb/11871402/12c988b4419b/JDI-16-535-g001.jpg

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