Unsatisfactory Glucose Management and Adverse Pregnancy Outcomes of Gestational Diabetes Mellitus in the Real World of Clinical Practice: A Retrospective Study

被引：6

作者：

Feng Ru ^{[1
,2
,3
]}

Liu Lu ^{[1
,2
,3
]}

Zhang YuanYuan ^{[4
]}

Yuan ZhongShang ^{[5
]}

Gao Ling ^{[3
,6
]}

Zuo ChangTing

机构：

[1] Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

[2] Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong, China

[3] Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China

[4] Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

[5] Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China

[6] Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

来源：

中华医学杂志英文版 | 2018年 / 131卷 / 09期

关键词：

Blood Glucose; Disease Management; Gestational Diabetes Mellitus; Pregnancy Outcome; Risk Factors;

D O I：

暂无

中图分类号：

R714.256 [内分泌腺病及代谢病];

学科分类号：

100211 ;

摘要：

Background: Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.Methods: The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age. The association between fasting plasma glucose (FPG) and adverse pregnancy outcomes was examined by logistic regression analyses.Results: The average prevalence of GDM over the 5 years was 4.4% (1330/30,191). Within the GDM patients, 42.8% (426/996) received dietary intervention, whereas 19.1% (190/996) received insulin treatment. Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome (RDS,χ2 = 13.373,P < 0.01). Elevated FPG was identified as an independent risk factor for premature birth (odds ratio [OR] = 1.460,P < 0.001), neonatal care unit admission (OR = 1.284,P < 0.001), RDS (OR = 1.322,P = 0.001), and stillbirth (OR = 1.427,P < 0.001).Conclusions: Management of GDM in the real world of clinical practice was unsatisfactory, which might have contributed to adverse pregnancy outcomes.

引用

页码：1079 / 1085

页数：7

共 12 条

[1]

Maternal and Neonatal Morbidity for Women Who Would Be Added to the Diagnosis of GDM Using IADPSG Criteria: A Secondary Analysis of the Hyperglycemia and Adverse Pregnancy Outcome Study[J] . Thaddeus P Waters,Alan R Dyer,Denise M Scholtens,Sharon L Dooley,Elaine Herer,Lynn P Lowe,Jeremy JN Oats,Bengt Persson,David A Sacks,Boyd E Metzger,Patrick M Catalano.Diabetes Care . 2016 (12)

[2]

Low Carbohydrate-Diet Scores and Long-term Risk of Type 2 Diabetes Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study[J] . Bao,Wei,Li,Shanshan,Chavarro,Jorge E,Tobias,Deirdre K,Zhu,Yeyi,Hu,Frank B,Zhang,Cuilin.Diabetes Care . 2016 (1)

[3] Treatment With Diet and Exercise for Women With Gestational Diabetes Mellitus Diagnosed Using IADPSG Criteria [J].

Kgosidialwa, Oratile ;

Egan, Aoife M. ;

Carmody, Louise ;

Kirwan, Breda ;

Gunning, Patricia ;

Dunne, Fidelma P. .

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2015, 100 (12) :4629-4636

[4]

The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care #[J] . Moshe Hod,Anil Kapur,David A. Sacks,Eran Hadar,Mukesh Agarwal,Gian Carlo Di Renzo,Luis Cabero Roura,Harold David McIntyre,Jessica L. Morris,Hema Divakar.International Journal of Gynecology and Obstetric . 2015

[5]

Prevention of gestational diabetes in pregnant women with risk factors for gestational diabetes: a systematic review and meta-analysis of randomised trials[J] . P Madhuvrata,Gemma Govinden,R Bustani,S Song,TA Farrell.Obstetric Medicine . 2015 (2)

[6]

Induction of labour or expectant monitoring in hypertensive pregnancy disorders at term: do women's postpartum cardiovascular risk factors differ between the two strategies?[J] . Wietske Hermes,Corine M. Koopmans,Maria G. van Pampus,Arie Franx,Kitty W.M. Bloemenkamp,Joris van der Post,Martina Porath,Jouke T. Tamsma,Ben W. Mol,Christianne J.M. de Groot.European Journal of Obstetrics and Gynecology . 2013 (1)

[7] Evaluation of the Value of Fasting Plasma Glucose in the First Prenatal Visit to Diagnose Gestational Diabetes Mellitus in China [J].

Zhu, Wei-wei ;

Yang, Hui-xia ;

Wei, Yu-mei ;

Yan, Jie ;

Wang, Zi-lian ;

Li, Xue-lan ;

Wu, Hai-rong ;

Li, Nan ;

Zhang, Mei-hua ;

Liu, Xing-hui ;

Zhang, Hua ;

Wang, Yun-hui ;

Niu, Jian-min ;

Gan, Yu-jie ;

Zhong, Li-ruo ;

Wang, Yun-feng ;

Kapur, Anil .

DIABETES CARE, 2013, 36 (03) :586-590

[8]

Incidence of adverse outcomes associated with gestational diabetes mellitus in low- and middle-income countries[J] . Zheng Wang,Lovney Kanguru,Julia Hussein,Ann Fitzmaurice,Katherine Ritchie.International Journal of Gynecology and Obstetrics . 2012

[9]

The Hyperglycemia and Adverse Pregnancy Outcome Study: Associations of GDM and obesity with pregnancy outcomes[J] . Catalano,Patrick M,McIntyre,H David,Cruickshank,J Kennedy,McCance,David R,Dyer,Alan R,Metzger,Boyd E,Lowe,Lynn P,Trimble,Elisabeth R,Coustan,Donald R,Hadden,David R,Persson,Bengt,Hod,Moshe,Oats,Jeremy J N.EN . 2012 (4)

[10]

Optimal Glycemic Control, Pre-eclampsia, and Gestational Hypertension in Women With Type 1 Diabetes in the Diabetes and Pre-eclampsia Intervention Trial[J] . Holmes,Valerie A,Young,Ian S,Patterson,Christopher C,Pearson,Donald W M,Walker,James D,Maresh,Michael J A,McCance,David R.Diabetes Care . 2011 (8)

← 1 2 →