PDF(Pubmed)
Abstract：
Gestational diabetes mellitus (GDM) could have a variable degree of adverse effects on pregnancy outcomes for both pregnant women and newborns. The purpose of the study was to explore the effect of GDM on pregnancy outcomes in advanced primiparous women. A total of 1076 advanced primiparous women were included between January 2020 and December 2022. All these women were divided into the GDM group (n = 434) and the non-GDM group (n = 642). Variables included baseline characteristics, maternal, and newborn outcomes were collected. The risk of each adverse outcome was analyzed by multivariate logistic regression models. The effect of blood glucose control on pregnancy outcomes was further analyzed among GDM women with good glycaemic control (n = 381) and poor glycaemic control (n = 53). Analysis of baseline characteristics demonstrated a significant difference in prepregnancy body mass index (median, IQR: 22.27 [20.58-24.44] vs 21.17 [19.53-22.86], P < .01) between the GDM group and the non-GDM group. A significantly higher incidence rate of adverse pregnancy outcomes was found in advanced primiparous women with GDM, such as polyhydramniosis, premature birth, low-birth weight, macrosomia, and neonatal intensive care unit admission (all P < .05). Compared with the non-GDM group, the risk of polyhydramniosis was nearly twice as high in the GDM group (adjusted odds ratio: 1.94, 95% confidence interval: 1.01-3.72, P = .04) after adjusted baseline characteristics. Among the GDM group, the women with poor glycaemic control showed a significantly higher incidence rate of polyhydramnios, hypertensive disorders of pregnancy, cesarean delivery, premature birth, low-birth weight, macrosomia, and neonatal intensive care unit admission was significant than the women with good glycaemic control (all P < .05). GDM was an independent risk factor for polyhydramnios in advanced primiparous women. At the same time, good glycaemic control in diabetics advanced primiparous women could reduce adverse pregnancy outcomes.
摘要：
妊娠期糖尿病（GDM）可能对孕妇和新生儿的妊娠结局产生不同程度的不利影响。目的探讨GDM对晚期初产妇妊娠结局的影响。在2020年1月至2022年12月期间，共有1076名初产妇被纳入。所有这些妇女被分为GDM组（n=434）和非GDM组（n=642）。变量包括基线特征，母性,并收集新生儿结局。采用多因素logistic回归模型分析各不良结局的风险。在血糖控制良好（n=381）和血糖控制不良（n=53）的GDM妇女中，进一步分析了血糖控制对妊娠结局的影响。基线特征分析显示孕前体重指数(中位数，IQR：22.27[20.58-24.44]vs21.17[19.53-22.86]，GDM组和非GDM组之间的P<.01）。妊娠不良结局的发生率明显高于GDM的初产妇。如羊水过多,早产,低出生体重,巨大儿,和新生儿重症监护病房入院（均P<0.05）。与非GDM组相比,在校正基线特征后,GDM组羊水过多的风险几乎是GDM组的两倍(校正比值比:1.94,95%置信区间:1.01~3.72,P=.04).在GDM组中，血糖控制不佳的妇女羊水过多的发生率明显较高，妊娠高血压疾病，剖宫产,早产,低出生体重,巨大儿,与血糖控制良好的妇女相比，新生儿重症监护病房的入院显着（均P<0.05）。GDM是晚期初产妇羊水过多的独立危险因素。同时,糖尿病晚期初产妇良好的血糖控制可以减少不良妊娠结局。
