Zhou Kaiyan, Chen Wenting, Wu Shuzhen, Li Lin, Xiang Yuting, Li Zhongjun
Guangdong Medical University, Zhanjiang, China.
Department of Obstetrics, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, China.
Arch Gynecol Obstet. 2025 May 30. doi: 10.1007/s00404-025-08047-x.
This study aimed to evaluate the impact of the timing of diabetes diagnosis on maternal and fetal outcomes.
The data were collected from pregnant women diagnosed with pregestational diabetes mellitus (PGDM) who were hospitalized at Dongguan People's Hospital between June 2016 and December 2023. Based on the timing of diagnosis, women were categorized into two groups: those diagnosed before pregnancy and those diagnosed during pregnancy. General clinical characteristics, glycemic control, pregnancy complications, and maternal and fetal outcomes were compared between the two groups to assess the influence of diagnosis timing on pregnancy outcomes.
Between 2016 and 2023, a total of 415 pregnant women with PGDM were included in this study. Among them, 242 (58.31%) were diagnosed before pregnancy, while 173 (41.69%) were diagnosed during pregnancy, resulting in a preconception diabetes awareness rate of 58.31%. Education level was significantly associated with the timing of diabetes diagnosis (P = 0.002). In addition, women diagnosed during pregnancy had significantly higher HbA1c levels before delivery when compared with those diagnosed before pregnancy (6.70% vs. 6.20%, P < 0.001), indicating more severe glycemic dysregulation. Consequently, this group also exhibited a higher rate of diabetes-related hospitalizations during pregnancy (42.77% vs. 22.73%, P < 0.001) and an increased risk of macrosomia (20.23% vs. 10.74%, P = 0.007).
Pregnant women diagnosed with diabetes during pregnancy exhibited more severe perinatal glucose metabolism disorders and a higher rate of macrosomia. Early diagnosis and management of diabetes-especially before conception-helped improve perinatal glycemic control, potentially reducing healthcare burdens and the incidence of macrosomia.
本研究旨在评估糖尿病诊断时间对母婴结局的影响。
收集2016年6月至2023年12月期间在东莞市人民医院住院的孕前糖尿病（PGDM）孕妇的数据。根据诊断时间，将女性分为两组：孕前诊断组和孕期诊断组。比较两组的一般临床特征、血糖控制情况、妊娠并发症以及母婴结局，以评估诊断时间对妊娠结局的影响。
2016年至2023年期间，本研究共纳入415例PGDM孕妇。其中，242例（58.31%）在孕前被诊断，173例（41.69%）在孕期被诊断，孕前糖尿病知晓率为58.31%。教育水平与糖尿病诊断时间显著相关（P = 0.002）。此外，与孕前诊断的女性相比，孕期诊断的女性分娩前糖化血红蛋白（HbA1c）水平显著更高（6.70% vs. 6.20%，P < 0.001），表明血糖调节异常更严重。因此，该组在孕期与糖尿病相关的住院率也更高（42.77% vs. 22.73%，P < 0.001），巨大儿风险增加（20.23% vs. 10.74%，P = 0.007）。
孕期被诊断为糖尿病的孕妇表现出更严重的围产期葡萄糖代谢紊乱和更高的巨大儿发生率。糖尿病的早期诊断和管理——尤其是在孕前——有助于改善围产期血糖控制，可能减轻医疗负担并降低巨大儿的发生率。
