Study On Glycosylated Albumin Levels And Adverse Maternal And Infant Outcomes In Patients With Gestational Diabetes Mellitus

Objective:In this study,patients with Gestational diabetes mellitus(GDM)and non-GDM pregnant women with normal glucose metabolism were tested for serum Glycated Albumin(GA),Fasting plasma glucose(FPG)and other related indexes of blood glucose before delivery.Medical history data during childbirth were tracked,maternal and infant adverse outcomes were recorded,and the relationship between GA level before delivery and maternal and infant complications in GDM patients was analyzed,so as to reduce clinical maternal and infant complications as far as possible through the control of GA level in pregnant women with GDM during pregnancy.Methods:A total of 331 pregnant women with GDM who delivered in the obstetric department of Xi’an Central Hospital from January 2015 to September 2020 were collected as the experimental group,and 366 pregnant women with normal glucose metabolism who delivered in obstetric department at the same time were selected as the normal control group.GDM was diagnosed according to the recommended criteria of China Guidelines for the Prevention and Treatment of Type 2 Diabetes(2020Edition).General information of the included subjects(name,age,gestational weeks,previous pregnancies,adverse pregnancy history,home address,etc.)was collected.GA,FPG and other related indicators were retrospectively analyzed,and the incidence of maternal and infant complications was collected according to the medical history of hospitalization.Statistical software SPSS25.0 was used for data analysis and processing.The measurement data(such as GA,FPG,newborn weight,Apgar score,etc.)were expressed as?x±s.The t test of two independent samples was used to compare the data in accordance with the normal distribution in pairs between groups.Enumeration data(such as the number of adverse outcomes in the mother and child)were expressed as a percentage(%)and compared between the two groups using the x~2 test.Spearman correlation analysis was used to study the correlation between GA and FPG before delivery in the two groups of pregnant women,and the difference was considered significant if P<0.05.Results:1.General information description:it is a significant difference between the mean gestational weeks,and the number of pregnancy in the GDM group than in the normal control group(P<0.05).However,we can not find significant differences between the two groups in the aspect of gestational weeks at birth and in indicators of adverse history of pregnancy.2.Description indexes of blood glucose:The antepartum values such as GA and FPG in the GDM group were higher than those in the normal group Control.The analysis of Spearman’s prenatal correlations for GA and FPG in both groups,which showed that GA and FPG were significantly positively correlated before delivery in the GDM group and healthy controls,respectively(r=0.150 and 0.310),P<0.05.3.Maternal and infant complications between the two groups:The birth weight of pregnant women in GDM group was higher than that in normal control group,the incidence of cesarean section and pregnancy hypertension was higher than that in control group,and the difference was significant(P<0.05).Newborns with birth weight≥4000g were defined as macrosomia,and stratified screening of offspring birth weight showed that the rate of macrosomia in the offspring of pregnant women in GDM group was higher than that of control group,and the difference was significant(P<0.05).However,no statistically significant differences were found between the two groups in other maternal and infant complications(preterm delivery,premature rupture of membranes,fetal distress,stillbirth,and neonatal Apgar score).4.Maternal and infant complications under different GA levels in GDM group:According to the median of GA,pregnant women in GDM group were divided into high GA group(GA≥10.33%)and low GA group(GA<10.33%).The incidence of cesarean section(56.6%),premature delivery(8.4%),premature rupture of membranes(21.1%),gestational hypertension(21.1%),neonatal weight(3.5±0.5kg),macrosomia(15.7%),fetal distress(13.3%)and stillbirth(1.2%)in the high GA group were all higher than those in the low GA group.Apgar score of neonates was lower than that of low GA group.There were only significant differences between the two groups in the incidence of cesarean section(x~2=4.133,P<0.05),gestational hypertension(x~2=7.264,P=0.007<0.05),and neonatal fetal distress(x~2=4.902,P<0.05).Conclusion:1.GA and FPG of GDM patients before delivery were higher than those of normal control group;2.The rates of cesarean section,gestational hypertension,birth weight and macrosomia in GDM patients were higher than those in the control group;3.When GDM patients had GA≥10.33%,cesarean section,gestational hypertension and fetal distress rates increased.