UNASSIGNED: A retrospective study of the Center for Perinatal Epidemiology registry was conducted. Demographic changes and adverse pregnancy outcomes were compared between a pre- and post-guideline period in women with and without hyperglycemia in pregnancy (HIP). Adjusted odds ratios with a 95% confidence interval (CI) were used to compare maternal and neonatal outcomes controlling for potential confounders (maternal age, body mass index (BMI), hypertension, parity, and multiple births).
UNASSIGNED: The prevalence of HIP increased (6.0%-9.2%). In the overall population regardless of glycemic status, gestational weight gain (12.3 ± 5.7 vs 11.9 ± 5.8; p < 0.001), hypertension (0.92; 95% CI, 0.89-0.94; p < 0.001), and neonatal intensive care unit/special care nursery (0.89; 95% CI, 0.87-0.91; p < 0.001) decreased despite increasing maternal age and pre-pregnancy BMI. Emergency cesarean section rates (1.07; 95% CI, 1.05-1.09; p < 0.001) increased, but not in the HIP population (1.02; 95% CI, 0.95-1.10; ns). The overall incidence of preterm birth (1.09; 95% CI, 1.06-1.12; p < 0.001), stillbirth (1.10; 95% CI, 1.01-1.21; p < 0.05), and perinatal mortality (1.10; 95% CI, 1.01-1.19; p < 0.05) increased, except in the HIP population (1.03; 95% CI, 0.95-1.11; ns), (1.04; 95% CI, 0.74-1.47; ns) and (1.09; 95% CI, 0.80-1.49; ns), respectively. The overall incidence of small- for-gestational-age remained unchanged (0.99; 95%CI, 0.97-1.01; ns) regardless of glycemic status. In the HIP population, large-for-gestational age (0.90; 95% CI, 0.84-0.95; p < 0.001) and macrosomia (0.84; 95% CI, 0.78-0.92; p < 0.001) decreased.
UNASSIGNED: After the implementation of IADPSG/WHO guidelines, the prevalence of HIP increased by 53.7% and the incidence of major HIP-related pregnancy complications appears to be lower. However, we cannot conclude that the reduction of LGA-macrosomia is due to a better management of diabetes or due to greater recruitment of women with mild HIP associated with a lower risk of obstetrical complications.
UNASSIGNED:对围产期流行病学登记中心进行了一项回顾性研究。在有和没有妊娠期高血糖(HIP)的女性中,比较了指南前后的人口统计学变化和不良妊娠结局。使用具有95%置信区间(CI)的调整后的优势比来比较控制潜在混杂因素(产妇年龄,体重指数(BMI),高血压,奇偶校验,和多胎)。
未经评估:HIP的患病率增加(6.0%-9.2%)。在总体人群中,无论血糖状态如何,妊娠体重增加(12.3±5.7vs11.9±5.8;p<0.001),高血压(0.92;95%CI,0.89-0.94;p<0.001),尽管产妇年龄和孕前BMI增加,但新生儿重症监护病房/特殊护理托儿所(0.89;95%CI,0.87-0.91;p<0.001)下降。急诊剖宫产率(1.07;95%CI,1.05-1.09;p<0.001)增加,但不在HIP人群中(1.02;95%CI,0.95-1.10;ns)。早产的总发生率(1.09;95%CI,1.06-1.12;p<0.001),死产(1.10;95%CI,1.01-1.21;p<0.05),围产期死亡率(1.10;95%CI,1.01-1.19;p<0.05)增加,除了HIP人群(1.03;95%CI,0.95-1.11;ns),(1.04;95%CI,0.74-1.47;ns)和(1.09;95%CI,0.80-1.49;ns),分别。无论血糖状态如何,小于胎龄的总体发生率保持不变(0.99;95CI,0.97-1.01;ns)。在HIP人群中,大于胎龄(0.90;95%CI,0.84-0.95;p<0.001)和巨大儿(0.84;95%CI,0.78-0.92;p<0.001)降低。
未经评估:实施IADPSG/WHO指南后,HIP的患病率增加了53.7%,与HIP相关的主要妊娠并发症的发生率似乎较低.然而,我们不能得出结论,LGA-巨大儿的减少是由于糖尿病治疗的改善,或者是由于轻度HIP的女性招募更多与产科并发症风险较低相关.