Sartayeva Aigul, Kudabayeva Khatima, Abenova Nurgul, Bazargaliyev Yerlan, Danyarova Laura, Adilova Gulnaz, Zhylkybekova Aliya, Tamadon Amin
Department of General Medical Practice No. 2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Department of Internal Diseases No. 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Int J Womens Health. 2025 Mar 19;17:865-877. doi: 10.2147/IJWH.S486267. eCollection 2025.
Gestational diabetes mellitus (GDM) is a common complication during pregnancy that poses considerable risks to both maternal and fetal health. However, its effect on cardiac autonomic function, measured by heart rate variability (HRV), remains uncertain. This study aims to investigate potential alterations in cardiac autonomic function in women diagnosed with GDM.
In this cross-sectional study, 80 Kazakh pregnant women in their third trimester with GDM were enrolled from the endocrinology department of Aktobe Medical Center between January and April 2023. A control group of 30 third-trimester pregnant women without GDM was also selected from outpatient clinics in Aktobe City. HRV was measured with participants in a seated position. A nomogram was developed to predict GDM risk, integrating relevant parameters associated with the condition.
Women with GDM were found to be older than those in the control group (p=0.005), though there were no significant differences in education level, employment status, or parity between the two groups. GDM was associated with larger fetal size (p=0.035) and a higher incidence of miscarriages and abortions (p<0.05) compared to the control group. Additionally, obesity was more prevalent among women with GDM (p<0.05). HRV parameters showed no significant differences between the GDM group and healthy pregnant women. The nomogram demonstrated good predictive accuracy, with an area under the curve of 0.7847 in the training cohort.
The nomogram developed in this study may prove useful for clinicians and patients in making informed clinical decisions and assessing outcomes. Notably, no significant differences in HRV were observed between women with uncomplicated pregnancies and those with GDM.
妊娠期糖尿病(GDM)是孕期常见的并发症,对母婴健康构成相当大的风险。然而,其对通过心率变异性(HRV)测量的心脏自主神经功能的影响仍不确定。本研究旨在调查诊断为GDM的女性心脏自主神经功能的潜在改变。
在这项横断面研究中,2023年1月至4月期间,从阿克托别医疗中心内分泌科招募了80名孕晚期患有GDM的哈萨克族孕妇。还从阿克托别市的门诊诊所选取了30名无GDM的孕晚期孕妇作为对照组。让参与者坐着测量HRV。开发了一种列线图来预测GDM风险,整合了与该疾病相关的参数。
发现患有GDM的女性比对照组年龄更大(p = 0.005),尽管两组在教育水平、就业状况或产次方面没有显著差异。与对照组相比,GDM与胎儿体型较大(p = 0.035)以及流产和堕胎发生率较高(p < 0.05)相关。此外,GDM女性中肥胖更为普遍(p < 0.05)。HRV参数在GDM组和健康孕妇之间没有显著差异。列线图显示出良好的预测准确性,训练队列中的曲线下面积为0.7847。
本研究中开发的列线图可能对临床医生和患者做出明智的临床决策和评估结果有用。值得注意的是,未观察到无并发症妊娠的女性与患有GDM的女性之间在HRV方面有显著差异。