Unsatisfactory Glucose Management and Adverse Pregnancy Outcomes of Gestational Diabetes Mellitus in the Real World of Clinical Practice： A Retrospective Study  

作　　者：Ru Feng Lu Liu Yuan-Yuan Zhang Zhong-Shang Yuan Ling Gao Chang-Ting Zuo 

机构地区：[1]Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China [2]Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, Shandong 250021, China [3]Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China [4]Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China [5]Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong 250012, China [6]Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China

出　　处：《Chinese Medical Journal》2018年第9期1079-1085,共7页中华医学杂志（英文版）

摘　　要：Background：Facing the increasing prevalence of gestational diabetes mellitus （GDM）,this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.Methods：The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected.Treatments during pregnancy and the last hospital admission before delivery were analyzed.Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age.The association between fasting plasma glucose （FPG） and adverse pregnancy outcomes was examined by logistic regression analyses.Results：The average prevalence of GDM over the 5 years was 4.4％ （1330/30,191）.Within the GDM patients,42.8％ （426/996） received dietary intervention,whereas 19.1％ （190/996） received insulin treatment.Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome （RDS,x2 =13.373,P ＜ 0.01）.Elevated FPG was identified as an independent risk factor for premature birth （odds ratio [OR] =1.460,P ＜ 0.001）,neonatal care unit admission （OR =1.284,P ＜ 0.001）,RDS （OR=1.322,P =0.001）,and stillbirth （OR =1.427,P ＜ 0.001）.Conclusions：Management of GDM in the real world of clinical practice was unsatisfactory,which might have contributed to adverse pregnancy outcomes.Background：Facing the increasing prevalence of gestational diabetes mellitus （GDM）,this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.Methods：The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected.Treatments during pregnancy and the last hospital admission before delivery were analyzed.Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age.The association between fasting plasma glucose （FPG） and adverse pregnancy outcomes was examined by logistic regression analyses.Results：The average prevalence of GDM over the 5 years was 4.4％ （1330/30,191）.Within the GDM patients,42.8％ （426/996） received dietary intervention,whereas 19.1％ （190/996） received insulin treatment.Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome （RDS,x2 =13.373,P ＜ 0.01）.Elevated FPG was identified as an independent risk factor for premature birth （odds ratio [OR] =1.460,P ＜ 0.001）,neonatal care unit admission （OR =1.284,P ＜ 0.001）,RDS （OR=1.322,P =0.001）,and stillbirth （OR =1.427,P ＜ 0.001）.Conclusions：Management of GDM in the real world of clinical practice was unsatisfactory,which might have contributed to adverse pregnancy outcomes.

关 键 词：Blood Glucose Disease Management Gestational Diabetes Mellitus Pregnancy Outcome Risk Factors 

分 类 号：TS218[轻工技术与工程—粮食、油脂及植物蛋白工程] S828[轻工技术与工程—食品科学与工程]