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Abstract：
Objective The aim of this study is to compare the rate of spontaneous preterm delivery between gestational diabetes mellitus (GDM) and normal pregnancy. Pregnancy outcomes and associated risk factors for spontaneous preterm delivery were evaluated. Methods A retrospective cohort study was conducted on 120 GDM and 480 normal pregnant women. All women received GDM screening with 50-g glucose challenge test and 100-g oral glucose tolerance test at the first visit and repeated at 24-28 weeks. Data were retrieved from medical records and included baseline and obstetric characteristics, preterm risks, GDM risks, and pregnancy outcomes. Spontaneous preterm birth was defined as delivery before 37 completed weeks of gestation that had been preceded by spontaneous labor. Results GDM women were more likely to be ≥30 years (p=0.032) and have previous GDM (p=0.013). Incidence of overall preterm delivery was significantly higher in GDM women (17.5% vs. 8.5%, p=0.004), as well as the incidence of spontaneous preterm delivery (15.8% vs. 7.1%, p=0.004). GDM women had less gestational weight gain (p<0.001) and were less likely to have excessive weight gain (p=0.002). GDM women were more likely to deliver large for gestational age (LGA) (p=0.02) and macrosomic infants (p=0.027). Neonatal hypoglycemia was significantly more common among GDM women (p=0.013). Multivariate analysis showed that previous preterm birth and GDM independently increased the risk of spontaneous preterm delivery (adjusted OR: 2.56, 95% CI: 1.13-5.79, p=0.024, and adjusted OR: 2.15, 95% CI: 1.2-3.84, p = 0.010, respectively). Conclusion GDM and previous preterm birth significantly increased the risk of spontaneous preterm delivery. GDM also increased the risk of LGA, macrosomia, and neonatal hypoglycemia.
摘要：
目的比较妊娠期糖尿病(GDM)与正常妊娠自发性早产的发生率。评价自发性早产的妊娠结局和相关危险因素。方法对120例GDM和480例正常孕妇进行回顾性队列研究。所有女性在首次就诊时接受了50-g葡萄糖激发试验和100-g口服葡萄糖耐量试验的GDM筛查，并在24-28周重复。数据从病历中检索，包括基线和产科特征，早产风险,GDM风险，和妊娠结局。自发性早产定义为在妊娠37周之前分娩，然后是自发性分娩。结果GDM女性年龄≥30岁（p=0.032）且既往有GDM（p=0.013）的可能性更大。GDM妇女的总体早产发生率明显更高（17.5％vs.8.5%,p=0.004),以及自发性早产的发生率(15.8%vs.7.1%,p=0.004)。GDM妇女的妊娠期体重增加较少（p<0.001），并且不太可能过度体重增加（p=0.002）。GDM妇女更有可能分娩大胎龄（LGA）（p=0.02）和大体性婴儿（p=0.027）。新生儿低血糖在GDM女性中明显更常见(p=0.013)。多因素分析显示，既往早产和GDM独立增加了自发性早产的风险（校正OR：2.56，95％CI：1.13-5.79，p=0.024，校正OR：2.15，95％CI：1.2-3.84，p=0.010）。结论GDM和既往早产显著增加了自发性早产的风险。GDM也增加了LGA的风险，巨大儿,和新生儿低血糖。
