Abstract
BackgroundThe purposes of this study were to explore whether the maternal-fetal outcomes differed among various types of hyperglycemia during pregnancy and whether the values of glycemic screening in the middle phase of pregnancy could predict maternal-fetal outcomes.MethodsA retrospective study was conducted to study the incidence of maternal-fetal outcomes in 383 singleton pregnant women with diabetes or gestational diabetes admitted to our hospital from November 2007 to March 2013. Patients were divided into three groups: DM (Type 1 and Type 2 diabetes mellitus) group, mGDM (mild gestational diabetes mellitus) group and sGDM (severe gestational diabetes mellitus) group. Maternal basic characteristics, results of oral glucose tolerance test (OGTT), antenatal random glycemia and maternal-fetal outcomes were collected. Binary logistic regression was used to estimate the association of blood glucose with the maternal-fetal outcomes. Predictive accuracy was assessed by calculating the areas under the receiver operating characteristic curves.ResultsThe maternal basic characteristics, maternal complications and neonatal complications did not differ significantly between DM group and sGDM group, except neonatal intensive care units admission (NICU). Incidences of preterm, NICU and preeclampsia were significantly lower in the mGDM group than in the DM and sGDM groups (P < 0.05). After adjusted by confounding factors, the value of OGTT 0 h could predict pregnancy induced hypertension (PIH) (OR = 1.24, 95% CI [1.04 to 1.46], P = 0.015), preterm birth (OR = 1.23, 95% CI [1.03 to 1.47], P = 0.025) and stillbirth (OR = 1.55, 95% CI [1.14 to 2.10], P = 0.005); antenatal random glycemia could predict preterm birth (OR = 1.19, 95% CI [1.08 to 1.31], P < 0.001) and stillbirth (OR = 1.41, 95% CI [1.17 to 1.71], P < 0.001).ConclusionsPregnant women in the mGDM group have better outcomes than those in the DM and sGDM groups. The values of OGTT in the middle phase of pregnancy and antenatal random glycemia could predict PIH, preterm birth or stillbirth to some extent.
Highlights
The purposes of this study were to explore whether the maternal-fetal outcomes differed among various types of hyperglycemia during pregnancy and whether the values of glycemic screening in the middle phase of pregnancy could predict maternal-fetal outcomes
Study subjects This was a retrospective study of 383 singleton pregnant women with pre-existing diabetes mellitus (DM) or gestational diabetes mellitus (GDM) and their offspring who delivered in Tongji Hospital affiliated to Huazhong University of Science and Technology from November 2007 to March 2013
There was no significant difference between DM group and sGDM group in maternal basic characteristics, maternal complications and neonatal complications except neonatal intensive care units (NICU) admission
Summary
The purposes of this study were to explore whether the maternal-fetal outcomes differed among various types of hyperglycemia during pregnancy and whether the values of glycemic screening in the middle phase of pregnancy could predict maternal-fetal outcomes. If the fasting glucose ≥ 7 mmol/L or HbA1c ≥6.5% or oral glucose tolerance test (OGTT) 2 h ≥ 11.1 mmol/L, one should be considered to be pre-diabetes [24] The management of this kind of severe gestational diabetes mellitus (sGDM) might be more demanding than mild gestational diabetes mellitus (mGDM) [22]. Until recently, it is not clear that whether differences exist in maternal-fetal outcomes among various types of hyperglycemia and whether the values of glycemic screening in the middle phase of pregnancy could predict specific maternal-fetal outcomes. The aims of our study were to explore that 1) whether the maternal-neonatal outcomes differed among various types of hyperglycemia during pregnancy; 2) whether the values of OGTT and antenatal random glycemia could predict specific maternal or neonatal complications
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