Analysis Of Abnormal Blood Glucose And Pregnancy Outcomes From Different Phases Of Gestational Diabetes

Objective1.To study the correlation between abnormal blood glucose levels and pregnancy outcomes in patients with gestational diabetes mellitus(GDM)75 grams of oral glucose tolerance test(OGTT).2.Analyze and compare the difference of abnormal blood glucose and pregnancy outcomes from different phases under different glycemic control conditions3.To provide evidence for future research by evaluating of individuals by studying the differences in pregnancy outeomes from different phases of blood glucose levels abnormalities.Method1.From January 1,2016 to December 31,2017,a total of 997 medical records of patients with single-child delivery were retrospectively analyzed at the Changzhou Second People's Hospital affiliated to Nanjing Medical University.2.The target value of blood glucose control is Fasting plasma glucose(FPG)of 3.3-5.3mmol/l,nighttime blood glucose and postprandial blood glucose of 4.4-6.7mmol/1.Diet and exercise were given to control blood sugar,and timely use of insulin after treatment to monitor blood sugar to achieve the target value of good blood sugar control group.Diet and exercise control of blood glucose did not reach the target value,refused to use insulin treatment,or after the use of insulin still did not reach the target value is considered poor blood glucose control.Compare the patient's age,pregnancy,birth,body mass index(BMI),neonatal birth weight(NBW)and hyperpensive disorder complicating pregnancy(HDCP),postpartum Postpartum hemorrhage(PPH),premature rupture of fetal membranes(PROM),cesarean section,premature delivery,low birth weight,macrosomia,neonatal jaundice,neonatal asphyxia,and insulin use.The occurrence of HDCP,PPH,PROM,premature delivery,low birth weight infants,giant children,neonatal jaundice,and neonatal asphyxia are classified as adverse pregnancy outcomes.3.According to different time points of OGTT,it is divided into groups A,B and C.Group A(1 point of high blood glucose)included:FPG group,lh group,2h group.Group B(2 points of high blood glucose)included:FPG+lh group,FPG+2h group,1h+2h group.Group C(3 points of high blood glucose)was:FPG+1h+2h high blood glucose group.In the ABC group,the A group,and the B group,the differences in each group were compared under the condition that the blood glucose control was good,and the difference in each group in the case of poor glycemic control.4.Statistieal processing:Data analysis was performed using SPSS 25 statistical software.The measurement data were expressed as:mean ± standard deviation,using t-test,U test and one-way analysis of variance.Counting the number of cases(percentage),using chi-square test,one-way ANOVA.The comparison results of data between groups were analyzed by one-way ANOVA and LSD method.P<0.05 was considered statistically significant.Results1.All the patients in the group with good blood glucose control were 476 cases and 521 cases in the control group.In age,NBW,HDCP,PROM,macrosomia,and cesarean section,the group with poor blood glucose control was significantly higher than the group with good blood glucose control(P<0.05).2.Comparison of blood glucose control is goodComparison results between A,B and C groups:group A was significantly lower in the age,premature delivery,low birth weight children than the other groups(P<0.05).Group C was significantly higher in hypertension,insulin use,and adverse pregnancy outcomes than the other two groups(P<0.05).Group C was significantly higher than group A in pregnancy,prenatal BMI,and cesarean section(P<0.05).Group B was significantly higher in neonatal jaundice than in group C(P<0.05).Comparison of results in group A(1 phase with high blood glucose):the age of the 2h group was significantly higher than that of the FPG group,and the prenatal BMI was significantly lower than that of the FPG group(P<0.05).The lh group and the 2h group were significantly higher than the fasting group in the PROM and neonatal jaiundice(P<0.05).Comparison of results in group B(2 phases with high blood glucose):the prenatal BMI of the FPG+1h group was significantly higher than that of the 1h+2h group(P<0.05).The NBW of the 1h+2h group was significantly lower than the other groups(P<0.05).3.Comparison of blood glucose control is not goodComparison of the three groups of ABC:Group C was significantly higher in HDCP,insulin use,macrosomia and adverse pregnancy outcomes than the other groups(P<0.05).Group C was significantly higher on NBW than group B(P<0.05),significantly higher in preterm delivery than in group A(P<0.05),and significantly lower in group B than in group B(P<0.05).Comparison of results in group A(1 phase with high blood glucose):the age of the 2h group was significantly higher than the fasting group(P<0.05).The lh group was significantly higher in the neonatal jaundice than in the fasting group(P<0.05).Comparison of results in group B(2 phases with high blood glucose):showed that fasting+1 hour group was significantly higher than the other two groups in macrosomia(P<0.05).Conclusion:1.The control of blood glucose in patients with gestational diabetes can significantly reduce the occurrence of adverse pregnancy outcomes.2.In the case of abnormal blood glucose from different phases in OGTT,regardless of whether the blood glucose control is good or not,the pregnancy outcome is still different.3.The older OGTT blood glucose abnormalities in older patients.With the increase of age,the abnormality of blood glucose is more serious,so it is recommended to complete birth at the appropriate reproductive age and reduce the occurrence of GDM.Early measures should be taken to prevent high blood glucose in pregnant women.4.When fasting blood glucose is high or OGTT3 time point blood sugar is high,we should avoid BMI before high yield.5.The incidence of HDCP in patients with gestational diabetes is high,while strict control of blood glucose,it is still necessary to prevent the occurrence of HDCP early.6.When the fasting blood glucose is high and the blood glucose is high for 1 hour,it is more necessary to control the growth of the fetus and avoid the occurrence of high NBW,especially giant baby.7.OGTT 3 phases of high blood glucose,suggesting that blood glucose is abnormally serious,easily lead to cesarean section,insulin use,and premature infants,low birth weight and other adverse outcomes.8.When the postprandial blood glucose rises,it is necessary to closely assess the intrauterine condition,as well as the birth of the newborn,early treatment of neonatal jaundice and avoid neonatal asphyxia.