Pregnancy outcomes in women with gestational diabetes: specific subgroups might require increased attention
Authors:
V. Bartáková 1; V. Ťápalová 2; K. Wágnerová 2; P. Janků 2; J. Bělobrádková 3; K. Kaňková 1
Authors‘ workplace:
Ústav patologické fyziologie LF MU, Brno, přednostka ústavu prof. MUDr. A. Vašků, CSc.
1; Gynekologicko-porodnická klinika FN, Brno, přednosta kliniky prof. MUDr. P. Ventruba, DrSc., MBA
2; Interní gastroenterologická klinika FN, Brno, přednosta kliniky prof. MUDr. A. Hep, CSc.
3
Published in:
Ceska Gynekol 2017; 82(1): 16-23
Overview
Objectives:
To compare peri-partal parameters between two groups of pregnant women – with and without gestational diabetes mellitus (GDM), to correlate degree of glucose abnormality with incidence of peri-partal morbidity and, finally, to analyse the potential effect of comorbidities (i.e. obesity, hypertension, thyreopathy, polycystic ovary syndrome, trombophylia, anemia, allergy, smoking) on pregnancy outcomes.
Design:
Epidemiological observational „case-control“ study.
Setting:
Department of Obstetric and Gynaecology, Faculty Hospital Brno; Department of Internal Medicine, Diabetes Centre, Faculty Hospital Brno; Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno.
Methods:
The study comprised 432 pregnant women (364 with GDM diagnosis, 68 healthy controls) followed during a period 2011–2013. GDM was diagnosed by oral glucose tolerance test in 24–28th week of gestation (by fasting plasma glucose >5,6 mmol/l or >8,8 mmol/l in 60th min or >7,8 mmol/l in 120th min post-75g glucose load). Following peri-partal parameters were studied: ultrasonographic examination before delivery, a date of delivery, length of childbirth, induction, perinatal complications, post-delivery complications, section, abnormity in pH, base excess, Apgar score, birth weight.
Results:
Subjects with GDM had significantly increased rate of labour induction compared to healthy controls (P = 0.0035, chi-square test). Subgroup of GDM women classified as having a higher risk for adverse perinatal outcomes by a definition of Czech Obstetric and Gynaecology Society had significantly more labour inductions, more sections and instrumental deliveries. New-borns of those mothers had significantly more common worse perinatal outcomes (Apgar score and macrosomia).
Conclusion:
Based on our data risk stratification of GDM subjects according to Czech Obstetric and Gynaecology Society appears relevant and justified.
Keywords:
gestational diabetes mellitus, pregnancy, impaired glucose tolerance, perinatal morbidity
Sources
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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
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