Association between hyperglycemia in middle and late pregnancy and maternal-fetal outcomes: a retrospective study.
BACKGROUND
The purposes of this study were to explore whether the maternal-fetal outcomes differed among various types of hyperglycemia during pregnancy and whether the values of glycemic screening in the middle phase of pregnancy could predict maternal-fetal outcomes.


METHODS
A retrospective study was conducted to study the incidence of maternal-fetal outcomes in 383 singleton pregnant women with diabetes or gestational diabetes admitted to our hospital from November 2007 to March 2013. Patients were divided into three groups: DM (Type 1 and Type 2 diabetes mellitus) group, mGDM (mild gestational diabetes mellitus) group and sGDM (severe gestational diabetes mellitus) group. Maternal basic characteristics, results of oral glucose tolerance test (OGTT), antenatal random glycemia and maternal-fetal outcomes were collected. Binary logistic regression was used to estimate the association of blood glucose with the maternal-fetal outcomes. Predictive accuracy was assessed by calculating the areas under the receiver operating characteristic curves.


RESULTS
The maternal basic characteristics, maternal complications and neonatal complications did not differ significantly between DM group and sGDM group, except neonatal intensive care units admission (NICU). Incidences of preterm, NICU and preeclampsia were significantly lower in the mGDM group than in the DM and sGDM groups (P < 0.05). After adjusted by confounding factors, the value of OGTT 0 h could predict pregnancy induced hypertension (PIH) (OR = 1.24, 95% CI [1.04 to 1.46], P = 0.015), preterm birth (OR = 1.23, 95% CI [1.03 to 1.47], P = 0.025) and stillbirth (OR = 1.55, 95% CI [1.14 to 2.10], P = 0.005); antenatal random glycemia could predict preterm birth (OR = 1.19, 95% CI [1.08 to 1.31], P < 0.001) and stillbirth (OR = 1.41, 95% CI [1.17 to 1.71], P < 0.001).


CONCLUSIONS
Pregnant women in the mGDM group have better outcomes than those in the DM and sGDM groups. The values of OGTT in the middle phase of pregnancy and antenatal random glycemia could predict PIH, preterm birth or stillbirth to some extent.
Juan
J
Gui
Aizhen
A
Li
Xiaoling
X
Su
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji medical college, Huazhong University of Science and Technology, Wuhan, Hubei, China. tjobg2012@163.com.
Ling
L
Feng
D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D046110:Hypertension, Pregnancy-Induced / Q000097:blood*; D015994:Incidence; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D011225:Pre-Eclampsia / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood; D011263:Pregnancy Trimester, Third / Q000097:blood; D011254:Pregnancy in Diabetics / Q000097:blood*; D047928:Premature Birth / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D050497:Stillbirth
D001786:Blood Glucose