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The association between maternal hyperglycemia and perinatal outcomes in gestational diabetes mellitus patients: A retrospective cohort study

Authors
 Hee Young Cho  ;  Inkyung Jung  ;  So Jung Kim 
Citation
 MEDICINE, Vol.95(36) : 4712, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Blood Glucose* ; Female ; Fetal Macrosomia/blood* ; Humans ; Hypoglycemia/etiology* ; Infant, Newborn ; Male ; Pregnancy ; Retrospective Studies
Keywords
fasting blood glucose ; gestational diabetes mellitus ; 50-g glucose challenge test ; oral glucose tolerance test ; perinatal outcomes
Abstract
Pregnancies complicated by gestational diabetes mellitus (GDM) are associated with increased risks of adverse maternal and fetal outcomes. The risks of adverse pregnancy outcomes differ depending on the glucose values among GDM patients. For accurate and effective prenatal counseling, it is necessary to understand the relationship between different maternal hyperglycemia values and the severity of adverse outcomes. With this objective, this study reexamines the relationship between maternal hyperglycemia versus maternal and perinatal outcomes in GDM patients. For this study, maternal hyperglycemia was diagnosed using the 2-step diagnostic approach.Medical records of 3434 pregnant women, who received the 50-g glucose challenge test (GCT) between March 2001 and April 2013, were reviewed. As a result, 307 patients were diagnosed with GDM, and they were divided into 2 groups according to their fasting glucose levels. A total of 171 patients had normal fasting glucose level (<95?mg/dL), and 136 patients had abnormal fasting glucose level (≥95?mg/dL). The 50-g GCT results were subdivided by 20-unit increments (140-159, n = 123; 160-179, n = 84; 180-199, n = 50; and ≥200, n = 50), and the maternal and perinatal outcomes were compared against the normal 50-g GCT group (n = 307).Maternal fasting blood glucose (FBG) level showed clear association with adverse perinatal outcomes. The odds ratio (OR) of macrosomia was 6.72 (95% CI: 2.59-17.49, P?<?0.001) between the 2 groups. The ORs of large for gestational age (LGA) and neonatal hypoglycemia were 3.75 (95% CI: 1.97-7.12, P?<?0.001) and 1.65 (95% CI: 0.79-3.43, P? = ?0.183), respectively. Also, the results of the 50-g GCT for each category showed strong association with increased risks of adverse perinatal outcomes compared to the normal 50-g GCT group. The OR of macrosomia (up to 20.31-fold), LGA (up to 6.15-fold), and neonatal hypoglycemia (up to 84.00-fold) increased with increasing 50-g GCT result.
Files in This Item:
T201603755.pdf Download
DOI
10.1097/MD.0000000000004712
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152156
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