The Relationship Between Gestational Diabetes Mellitus And Pregnancy Outcomes

Objective:1、Analyze the effect on pregnancy outcomes of gestational diabetesmellitus(GDM), to provide certain reference for empirical research.2、Study the relationship between gestational diabetes mellitus and pregnancyoutcomes, to provide a better method of prevention and treatment of GDM in order toimprove the level of maternal and perinatal health.Methods:1、Literature search: Collected relative cohort study literatures have beenpublished in China from the year of2010to2011.The data were analysed through theReview Manager5.1and Odds Ratio(OR) and95%confidence intervals (CIs) were thencalculated and pooled using a fixed-effects model. Key words are gestational diabetesmellitus or GDM.2、Empirical investigation: Collected742clinical cases’data of pregnancy womenwith GDM and without other internal medicine diseases from a certain hospital.Meanwhile selected742clinical cases of normal pregnancy women as compared group.The Epi Data3.1software was used to create the database; entry and check data. PASWStatistic18.0software was used to statistically analysis the data. Compared whetherthere is a difference between gestational diabetes maternal and the normal maternalpregnancy outcomes, adopt the method of case-control study analysis the influencefactors of GDM in the city, analysis the influence of different level of blood glucoseconcentration on pregnancy outcomes of gestational diabetes maternal prenatal oralglucose tolerance test(OGTT), analysis the differences between different combinationsof influence factors of GDM on pregnancy outcomes. Results:1.Evidence-based analysis: Totally,17eligible studies of GDM were analyzedsynthetically by Meta-analysis. Total sample size is3680, the number of GDM groupand the control group were1469and2211respectively. The P value of every result islower than0.00001, difference have statistical significance.2. Empirical research:2.1Case-control study of GDMThe results of single factor analysis showed there was the statistical significantdifference among ages, BMI, prenatal weight, pregnant time, cultural degree, familyhistory of diabetes and abnormal pregnancy histories in GDM group, compared withcontrol group. The results of multiple-factor logistic analysis showed there that was thestatistical significant difference among age, BMI, family history of diabetes andabnormal pregnancy histories.2.2The influence of GDM on pregnancy outcomes: The incidence of hypertensivedisorders in pregnancy, intrahepatic cholestasis of pregnancy, polyhydramnios andcesarean section in GDM group were higher than control group (P<0.05), differencehave statistical significance. The incidence of premature delivery, macrosomia,hyperbilirubinemia of newborn, neonatal hypoglycemia and pneumonia of newborn inGDM group were higher than those in control group(P<0.05), difference have statisticalsignificance.2.3The impact on pregnancy outcomes of different plasma glucose level of GDM:Compared with the lowest blood glucose concentration group. For the different bloodglucose levels, the OR of gestational hypertension disease were3.78(95%CI,1.58-9.05),4.20(95%CI,1.71-10.31) and2.94(95%CI,1.37-6.30); the OR of preterm birth were2.95(95%CI,1.28-6.76) and3.41(95%CI,1.94-7.82); the OR of cesarean delivery were1.55(95%CI,1.03-2.32),2.13(95%CI,1.38-3.30) and1.70(95%CI,1.12-2.59); the OR ofmacrosomia were2.35(95%CI,1.06-5.21) and5.27(95%CI,2.45-11.31); the OR ofneonatal hypoglycemia was4.38(95%CI,1.24-15.41). All of the results above havestatistical significance.2.4The influence of GDM women have adverse pregnancy outcomes: The resultsof single factor analysis showed there were the statistical significant difference amongages, prenatal BMI, OGTT fasting glucose and abnormal pregnancy histories(P<0.05). The results of multiple-factor logistic analysis showed there was the statisticalsignificant difference among age, prenatal BMI and OGTT fasting glucose. Comparedwith GDM women who have no adverse pregnancy outcomes. The OR value of GDMwomen who have only one adverse pregnancy outcome was1.47(95%CI,1.13-1.91) inOGTT fasting glucose,1.07(95%CI,1.01-1.13) in age,1.31(95%CI,1.13-1.52) inprenatal BMI. The OR value of GDM women who have more than one adversepregnancy outcomes was1.65(95%CI,1.28-2.41) in OGTT fasting glucose,1.09(95%CI,1.03-1.15) in age,1.34(95%CI,1.17-1.55) in prenatal BMI. The resultshave statistical significance.2.5The relationship between GDM women with different number of risk factorand adverse pregnancy outcomes: Compared with GDM women who do not have anyrisk factor. The OR value of GDM women with two kinds of risk factors have adverseoutcomes was2.45(95%CI,1.29-4.65). The OR value of GDM women with more thantwo kinds of risk factors have adverse outcomes was4.29(95%CI,2.22-8.30). Theresults have statistical significance.Conclusions:1、Evidence-based research found that GDM increase the risk of gestationalhypertension, polyhydramnios and premature rupture of membranes of pregnant andlying-in women, and increase the risk of preterm birth, neonatal hypoglycemia andhigh neonatal bilirubin concentration of perinatal infant also.Provide the basis forempirical research.2、The empirical research found that GDM is still a serious threat to maternal andchild health especially the OGTT fasting glucose. Meanwhile maternal age, pregnancyBMI and abnormal pregnancy history are risk factors of adverse pregnancy outcomes.3、There is higher risk to have adverse pregnancy outcomes for pregnancy womenwith more than two risk factors.