Analyses Between Oral Glucose Tolerance Test Characteristics And Adverse Pregnancy Outcomes Among Women With Gestational Diabetes Mellitus

Objective:To investigate whether the abnormal values of fasting plasma glucose,1 hour postprandial blood glucose and 2 hour postprandial blood glucose in OGTT of gestational diabetes mellitus(GDM)have a profound influence on the complications of mothers and infants.Whether the more abnormal blood glucose points,the higher the incidence of maternal and infant complications.To explore whether the incidence of maternal and infant complications is lower when Hb A1 c < 5.9%.Methods: We observed singleton pregnant women who were waiting for delivery during the period of hospitalization from January 2012 to July2018 in the Department of Obstetrics of Hunan Provincial people's Hospital,and the number of women who met the inclusion criteria was529.Collect the age,gestational times,delivery times,height,weight and body mass of pregnant women when they enter our hospital,gestational week,birth weight of newborn,Apgar score of one minute,Apgar score of five minutes,maternal and infant complications,fasting blood glucose,random blood glucose,RBC count,platelet count,hemoglobin concentration,the biochemical indexes such as alanine aminotransferaseand glutamate oxaloacetate transaminase in liver function,creatinine and urea nitrogen in kidney function and blood glucose in newborn,as well as the results of oral glucose tolerance test(OGTT)measured at 24 ~ 28 weeks of pregnant women were collected.According to the results of OGTT,they were divided into two groups: normal pregnancy group and GDM group.The GDM group was divided into three groups according to the number of OGTT abnormal values:GDM1 group(one abnormal blood glucose value),GDM2 group(two abnormal blood glucose values),GDM3 group(three abnormal blood glucose values).The GDM1 group was divided into GDM1 a group(abnormal fasting blood glucose),GDM1 b group(abnormal 1 hour postprandial blood sugar),GDM1 c group(abnormal 2 hour postprandial blood sugar).The GDM group was divided into group A(HbA1c <5.9%)and group B(5.9%?Hb A1 c <6.5%).The difference and correlation of clinical,biochemical indexes and complications between the two groups were analyzed.Among the subjects who met the inclusion criteria,GDM group met the diagnostic criteria of gestational diabetes in the guidelines for the prevention and treatment of type 2 diabetes in China formulated by the Chinese Diabetes Society;blood glucose in the normal control group was within the normal reference range.Results: 1.Compared with the normal group,the body weight and body mass index of GDM group were higher,fasting plasma glucose(FPG)atadmission,fasting plasma glucose(FPG)in OGTT,1 hour postprandial blood sugar(1°PBS)and 2 hours postprandial blood sugar(2°PBS),red blood cells were higher,while platelets were lower.The difference was statistically significant(P<0.05).Compared with the normal group,the incidence of premature delivery,neonatal admission,neonatal hyperbi-lirubinemia,neonatal respiratory distress syndrome,neonatal hypogl-ycemia and macrosomia in GDM group were higher.The difference was statistically significant(P<0.05).2.Compared with the GDM1 group,the incidence of hyperbilirubinemia in the GDM2 group was higher,the body weight and body mass index in the GDM3 group were higher,the one minute and five minute scores were lower,placental abruption,premature rupture of membranes,premature delivery,neonatal admission,birth defects,neonatal hyperbilirubinemia,neonatal respiratory distress syndrome,neonatal infection,neo natal hypoglycemia were higher.The difference was statistically significant(P<0.05).Compared with the GDM2 group,the GDM3 group had higher body weight,body mass index and creatinine,lower one minute and five minute scores,higher incidence of placental abruption,preterm delivery,neonatal admission,hyperbilirubinemia and neonatal respiratory distress syndrome.The difference was statistically significant(P<0.05).3.Compared with the GDM1 a group,the GDM1 b group and the GDM1 cgroup had lower body weight and body mass index,lower incidence of birth defects,hyperbilirubinemia and neonatal hypoglycemia,and higher RBC in the GDM1 c group.The difference was statistically significant(P<0.05).Compared with the GDM1 b group,RBC of the GDM1 c group was higher.The difference was statistically significant(P<0.05).4.Compared with the group A,the incidence of body weight,body mass index,random blood glucose,hyperbilirubinemia,hypoglycemia and macrosomia in the group B was higher.The difference was statistically significant(P<0.05).Conclusion: 1.Pregnant women in GDM group are more likely to have maternal and infant complications than those in normal group.2.Different abnormal types of OGTT are related to different maternal and infant complications.Abnormal fasting blood glucose will lead to a higher incidence of maternal and infant complications.In general,with the increase of the abnormal blood glucose values of OGTT,the incidence of maternal and infant complications is higher.3.Pregnant women with gestational diabetes mellitus in the third trim-ester,when Hb A1 c < 5.9% the incidence of maternal and infant comp-lications was lower.