Abstract
Hyperglycemia is one of the most common conditions during pregnancy. The International Diabetes Federation (IDF) estimates that one in six live births (16.8%) are in women with some form of Hyperglycemia during pregnancy. The aim is to analyze the frequency of Hyperglycemia during pregnancy through a cross-sectional multicenter population-based study in 84 settlements in Bulgaria, as well as to study the dynamics of this frequency during pregnancy. Material: We studied 547 pregnant women with a mean age of 30±5 years, divided into two groups - up to 24 gestational week – g.w. (n-386, 70.6%) and after 24 g.w. (n-161, 29.4%). Methods: BMI before pregnancy and the current one at the time of the study were calculated. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. Plasma glucose was quantitatively determined using enzymatic reference method with hexokinase (Roche reagent) on Cobas е501 analyzer, in one Central laboratory on the day of the blood sampling. The results were in mmol / l. The statistical analysis was performed using standard SPSS 13.0 for Windows. Results: Hyperglycemia was observed in 79 (14.4%) pregnant women after fasting state or in the course of classic OGTT, according to the criteria of WHO’2019, FIGO’2015, NICE’2015, and in the remaining 468 (85.6%) pregnant women - Normoglycemia. There was no significant difference in the level of glycemia between the three trimesters for each of the points of OGTT (0, 60, 120 minutes) in the subgroups of pregnant women with Hyperglycemia (up to 12 g.w, 13-24 g.w, after 24 g.w.). It turned out that the number and frequency of pregnant women with Hyperglycemia in the period up to 24 g.w. is 7.5% (29/386) and increases in the period after 24 g.w. reaching 31% (50/161), P < 0.01. According to the generally accepted population diagnostic criteria for diabetes in non-pregnant women, we found that 8.9% (7/79) of pregnant women with Hyperglycemia had Diabetes in Pregnancy (DIP), all of whom had a risk factor for Diabetes (two of them even 3 risk factors). Conclusion: As soon as pregnancy is established, verbal screening for diabetes risk factors should be performed as a first step in selecting pregnant women for glucose tolerance screening with classic OGTT to determine the glucose status of the pregnant woman.
Highlights
In 1960, OSullivan et al first demonstrated that screening, diagnosis and treatment of Hyperglycemia in pregnant women not previously known to have Diabetes mellitus, improve the outcome of the current pregnancy [1].Hyperglycemia is one of the most common conditions during pregnancy
Fasting hyperglycemia or in the course of classic oral glucose tolerance test (OGTT), according to the criteria of World Health Organization (WHO) (2019), FIGO (2015), NICE (2015), was diagnosed in 79 (14.4%) pregnant women, and in the remaining 468 (85.6%) pregnant women we found Normoglycemia
The International Diabetes Federation states that about 15% of similar to that found in type 2 diabetes
Summary
In 1960, OSullivan et al first demonstrated that screening, diagnosis and treatment of Hyperglycemia in pregnant women not previously known to have Diabetes mellitus, improve the outcome of the current pregnancy [1].Hyperglycemia is one of the most common conditions during pregnancy. Anna-Maria Borissovа et al.: Cross-sectional Study of Glucose Disturbances of Pregnant Women in Bulgaria during pregnancy according to generally accepted population diagnostic criteria for diabetes (standard OGTT 75 g glucose): fasting plasma glucose ≥ 7.0 mmol / L or plasma glucose at 2 hours ≥ 11.1 mmol / L or HbA1c ≥ 48 mmol / mol or ≥ 6.5%. For pregnant women with already diagnosed Diabetes, it is recommended that capillary blood glucose to be fasted at 5.3 mmol / l, one hour after a meal - 7.8 mmol / l and two hours after a meal - 6.4 mmol / L.
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