Maternal 75 g oral glucose tolerance test levels as a predictive factor formaternal and neonatal outcomes in women with gestational diabetes mellitus:A Cross- Sectional Study

BACKGROUND<br>Gestational diabetes which affects 3% to 6% of all pregnancies is an important issue which should be handled with specific treatment in addition to routine antenatal care to reduce the risks of maternal and perinatal morbidity.METHODSThis was a one-year retrospective analysis of pregnant women with GDM who gave birth in our hospital between December 2020 and November 2021. We have a total of 5152 obstetric admissions, 3681 high risk cases, and 197 women diagnosed with gestational diabetes mellitus based on the IADPSG guideline. Due to incomplete data, 23 cases were excluded, bringing the total number of cases for final analysis to 174. Demographics , as well as their OGTT results, GDM treatment, mode of delivery, and maternal and neonatal outcomes, were all documented.RESULTS<br>For the 174 subjects, we calculated crude odds ratios for adverse pregnancy outcomes associated with abnormalities of the 75g OGTT, those patients with abnormal 1st hr 75g OGTT were more likely to have antepartum complications with odds ratio (OR) of 2.40 (95 % confidence interval [CI] 1.17 to 4.94), and have preterm babies with OR 4.2 ( 95% CI, 1.04 to 16.9). When all 3 criteria are elevated, patients were more likely to have antepartum complication with OD 3.09, (95% CI, 1.16 to 8.19), low APGAR score with OR 6.87 (95% CI 1.43- 34), and have preterm babies with OR 5.64 (95% CI 1.48- 21.5). There were no statistical significance on the other adverse pregnancy outcomesCONCLUSIONSOur results indicate that the 1- h OGTT values is positively predictive with adverse antepartum pregnancy outcomes and preterm births and abnormalities on all 3 criteria were found to be positive predictors of unfavorable antepartum outcomes, low APGAR score, and preterm births.

背景<br>妊娠糖尿病（Gestational Diabetes Mellitus, GDM）影响了3%至6%的妊娠人群，是一项亟待重视的临床问题：除常规产前保健外，还需辅以针对性治疗，以降低孕产妇及围产儿的发病风险。<br>方法<br>本研究为回顾性分析，纳入2020年12月至2021年11月于本院分娩的妊娠糖尿病患者。本中心同期产科总住院人次为5152例，其中高危妊娠病例3681例，依据国际糖尿病与妊娠研究组（International Association of Diabetes and Pregnancy Study Groups, IADPSG）指南确诊的妊娠糖尿病患者共197例。因数据不全排除23例，最终纳入分析的病例数为174例。研究记录了受试者的人口学特征、口服葡萄糖耐量试验（Oral Glucose Tolerance Test, OGTT）结果、GDM治疗方案、分娩方式以及孕产妇与新生儿结局。<br>结果<br>针对174例受试者，本研究计算了75g OGTT异常相关不良妊娠结局的粗比值比（crude Odds Ratio, cOR）。结果显示，OGTT 1小时血糖异常的患者，发生产期并发症的比值比（Odds Ratio, OR）为2.40（95%置信区间[CI]：1.17~4.94），早产风险的OR为4.2（95%CI：1.04~16.9）。当三项血糖判定标准均异常时，患者发生产期并发症的OR为3.09（95%CI：1.16~8.19），新生儿阿普加评分（Apgar Score）低下的OR为6.87（95%CI：1.43~34），早产风险的OR为5.64（95%CI：1.48~21.5）。其余不良妊娠结局未观察到统计学显著性差异。<br>结论<br>本研究结果表明，OGTT 1小时血糖值可正向预测不良产前妊娠结局与早产风险；三项判定标准均异常则可有效预测不良产前结局、新生儿阿普加评分低下及早产风险。