Postpartum Glucose Follow-up Screening Among Women With Gestational Diabetes Mellitus: A Retrospective Cohort Study  

作　　者：Jiani Zhang Tingting Xu Qi Cao Chihui Mao Fan Zhou Xiaodong Wang 

机构地区：[1]Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University,Chengdu,Sichuan 610041,China [2]Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu,Sichuan 610041,China [3]Department of Reproductive Medical Center,West China Second University Hospital,Sichuan University,Chengdu,Sichuan 610041,China

出　　处：《Maternal-Fetal Medicine》2024年第4期236-242,共7页母胎医学杂志（英文）

基　　金：supported by the Science Foundation of Sichuan Province(Grant No.2022YF0042).

摘　　要：Objective: To evaluate the impact of pregestational and gestational characteristics on postpartum glucose follow-up screening(PGFS)compliance in women diagnosed with gestational diabetes mellitus(GDM)in southwest China.Methods: This retrospective cohort study was conducted in West China Second Hospital,Sichuan University.Pregestational and gestational factors were extracted from hospital records and compared between women who completed PGFS and those who did not.The screening method chosen was the 75 g oral glucose tolerance test(OGTT),performed 4–12 weeks postpartum.Univariate analysis,logistic regression analysis,and Cochran-Armitage test were used to assess associations between maternal characteristics and PGFS compliance.Results: A total of 3047 women with GDM were included,with a PGFS completion rate of 47.2%.Of those who completed PGFS,430 women(29.9%)presented abnormal results:1.8%with impaired fasting glucose(IFG),24.1%with impaired glucose tolerance(IGT),2.2%with both IFG and IGT,and 1.8%with suspected diabetes.Independent factors associated with non-compliance to PGFS included higher pregestational BMI(odds ratio(OR):0.952;95%confidence interval(CI):0.922,0.984),multipara(OR:0.721;95%CI:0.593,0.877),use of assisted reproduction technology(ART)(OR:1.427;95%CI:1.080,1.885),excessive gestational weight gain(OR:0.956;95%CI:0.936,0.977),elevated fasting plasma glucose(FPG)prior to delivery(OR:0.909;95%CI:0.835,0.988),and undergoing cesarean section(OR:1.232;95%CI:1.017,1.492).PGFS completion rates significantly decreased with increasing pregestational BMI and earlier gestational age(P<0.001).Conclusion: Establishing dedicated postpartum follow-up teams and targeting women with higher pregestational BMI,multiparity,ART use,excessive gestational weight gain,elevated pre-delivery FPG,and those undergoing cesarean section are critical to improving postpartum GDM management.

关 键 词：Diabetes mellitus gestational FOLLOW-UP Influencing factors POSTPARTUM SCREENING 

分 类 号：R714.256[医药卫生—妇产科学]