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
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.
METHODS
This 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
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 75
g 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 outcomes
CONCLUSIONS
Our 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：妊娠期糖尿病（Gestational Diabetes Mellitus, GDM）在所有妊娠人群中的患病率为3%至6%，是一类需在常规产前保健基础上辅以针对性治疗的重要临床问题，以降低孕产妇及围产儿的发病风险。
方法：本研究为回顾性分析，纳入2020年12月至2021年11月期间于本院分娩的妊娠期糖尿病孕妇。研究期间本院共有产科住院人次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）指南确诊的妊娠期糖尿病孕妇共197例。因数据不完整，排除23例，最终纳入最终分析的病例数为174例。本研究记录了研究对象的人口学特征、口服葡萄糖耐量试验（Oral Glucose Tolerance Test, OGTT）结果、妊娠期糖尿病治疗方案、分娩方式以及母儿结局。
结果：针对174例研究对象，本研究计算了与75g口服葡萄糖耐量试验异常相关的不良妊娠结局的粗比值比。结果显示，口服葡萄糖耐量试验1小时血糖异常的孕妇发生产前并发症的比值比（OR）为2.40（95%置信区间[CI]：1.17~4.94），分娩早产儿的OR为4.2（95%CI：1.04~16.9）。当三项OGTT判定标准均升高时，孕妇发生产前并发症的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：1.43~34.0），分娩早产儿的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。
结论：本研究结果表明，口服葡萄糖耐量试验1小时血糖值可正向预测产前不良妊娠结局及早产儿分娩；三项判定标准均异常则可作为产前不良结局、新生儿阿普加评分低下及早产儿分娩的阳性预测指标。