A Study On The Risk Factors And Pregnancy Outcomes Of Gestational Glycometabolic Abnormality

Objective:To investigate the incidence of gestational glycometabolic abnormality in Liuyang and to explore the risk factors and pregnancy outcomes of gestational glycometabolic abnormality.Methods:14townships were randomly selected by cluster random sampling method from37townships in Liuyang. Objects of our study were maternal who registered in the Maternal and Child Health Hospital (stations) and were willing to participate in this study from January2010to October2011in these14townships. Objects who met the requirements of our study were followed up from early stage of pregnancy until delivery. Investigators were trained to collect the related information of our study and record it into the maternal health manual. Medical records were used as a complementary data resource. Statistical analyses were using Chi-squre tests and logistic regression analysis to investigate the risk factors and pregnancy outcome of gestational glycometabolic abnormality.Results:â‘ From January2010to October2012, a total of4693cases were included in the final analysis.145women were diagnosed as gestational glycometabolic abnormality (3.09%), including102women with gestational diabetes mellitus (2.17%) and43women with gestational impaired glucose tolerance (0.92%).â‘¡Risk factors analysis:Multivariate analysis results showed that:age (RR=1.571), BMI diagnosed at first visit (RR=1.734), weight gain (RR=1.261) and family history of diabetes (RR=5.488) were independent risk factors of gestational glycometabolic abnormality.â‘¢Impact on maternal and neonatal outcomes:Multivariate logistic regression results showed that:gestational glycometabolic abnormality increased the risks of premature delivery (GIGT group RR=4.699, GDM groupRR=5.434), macrosomia (GIGT group RR=3.280, GDM groupRR=3.413), and the risks of macrosomia increased with the degree of gestational glycometabolic abnormality. In addition, the risks of the gestational hypertension (RR=3.004) and cesarean section (RR=1.487) were higher in GDM group than in the control group, GDM group also had higher risk of postpartum hemorrhage after controlling for confounding factors (RR=2.294).Conclusion:â‘ The incidence of gestational glycometabolic abnormality in Liuyang was3.09%, gestational diabetes mellitus (GDM) rate was2.17%, gestational impaired glucose tolerance (GIGT) rate was0.92%.â‘¡Age, excessive weight gain during pregnancy, diagnosed with high BMI at first visit, family history of diabetes were independent risk factors for gestational glycometabolic abnormality. Pregnant women with these risk factors should be attached with more attention in the early screening management and health education, in order to detect and diagnose the gestational glycometabolic abnormality in time.â‘¢Gestational glycometabolic abnormality could increase the risk of macrosomia and premature delivery. In addition, women with gestational diabetes mellitus had higher risks of gestational hypertension, cesarean section and postpartum hemorrhage than normal pregnant women.â‘£Although GIGT is not severity as GDM, GIGT also had adverse effects on maternal and neonatal health, we should pay more attention to that. Women with GDM and GIGT should have reasonable therapeutic intervention in order to control blood sugar level and minimize the occurrence of adverse pregnancy outcomes.