Abstract
Gestational diabetes is a common disease among pregnant women. The fetoplacental complex plays a key role in fetal development and pregnancy maintenance. Research on placental hormonal function in women with gestational diabetes is important to improve pregnancy outcomes and maternal and child health. Aim - to analyze the hormonal function of the fetoplacental complex in women with gestational diabetes for improving monitoring and treatment algorithms of this condition to improve pregnancy outcome and improving mother’s and child’s health. Materials and methods. The main clinical, laboratory and functional studies were carried out at the following facilities: Kyiv City Maternity Hospital No. 5 and SI "Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine". 120 pregnant women were studied: 90 women with gestational diabetes (main group) and 30 women without placental dysfunction (control group). The average age of patients in the main group was 30.8±0.6 years, the control group was 30.4±0.5 years. The diagnosis of gestational diabetes was confirmed by laboratory and instrumental methods in accordance with FIGO recommendations. The functional activity of the fetoplacental complex was assessed by the level of placental lactogen, estriol and progesterone in the blood of women at 26-32 and 37-39 weeks of pregnancy. Statistical processing of the results was carried out using methods of variational and alternative statistics with using a computer program package. Results. The level of placental lactogen in gestational diabetes in the 26-32 week exceeds the level of healthy pregnant women by 10-16%. In patients with gestational diabetes, the concentration of progesterone in the 26-32 week is also lower than in healthy women, and after 36 weeks it is reduced by half. A decrease in progesterone of less than 25 percentile (pc) is associated with the threat of premature birth, and below 15 pc is characteristic of a violation of the condition of the fetus. Estriol levels in pregnant women with gestational diabetes decrease to 35.5 pc by the last weeks of pregnancy. In pregnant women with gestational diabetes and preeclampsia, a decrease in the level of placental lactogen and a moderate decrease in the content of estriol was noted, which indicates adverse changes in the mother-placenta-fetus system. Conclusions. Analysis of hormonal function in patients with gestational diabetes revealіs changes in estriol, placental lactogen, and progesterone associated with pregnancy complications. These data emphasize the importance of regular monitoring to prevent or treat complications. The research was carried out in accordance with the principles of the Helsinki Declartion. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Published Version
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