Relationship Between Glycemic Control Status And Pregnancy Outcome In Pregnant Women With Gestational Diabetes Mellitus

Objective:There is a correlation between hyperglycemia in pregnancy and adverse pregnancy outcomes.The purpose of this study was to analyze the relationship between glycemic control status and pregnancy outcomes,with the aim of providing clinical guidance to reduce the occurrence of adverse pregnancy outcomes.Methods:We retrospectively analyzed the data of 301 pregnant women with gestational diabetes mellitus only who delivered from June 2020 to November 2022 at the Ninth Clinical School of Shanxi Medical University,and divided them into good glycemic control group(HbA1c <5.5%,n = 180)and poor glycemic control group(HbA1c ≥5.5%,n = 180)according to glycosylated hemoglobin A1c(HbA1c)values at admission.The pregnancy outcomes of the three groups were compared by selecting 412 healthy pregnant women who delivered at the same period as the control group.Statistical methods such as ANOVA,χ~2 test(including the continuity correction method and Fisher’s exact probability method),and logistic regression analysis were used for analysis.Results:1.Comparison between the three groups showed statistically significant differences in age at delivery,pre-pregnancy body mass index,weight gain during pregnancy,week of pregnancy at termination,history of pregnancy and delivery,previous history of miscarriage,and family genetic history of diabetes(P < 0.05),while family history of hypertension was not statistically significant by statistical analysis(P > 0.05).The comparison between the two groups showed that the age at delivery was greater in both the well-controlled and poorly controlled groups than in the normal group,and the pre-pregnancy body mass index was higher than in the normal group;the weight gain during pregnancy was less than in the normal group;the gestational week at termination of pregnancy was earlier than in the normal group;the family history of diabetes was more than in the normal group;the weight gain during pregnancy was higher in the poorly controlled group than in the well-controlled group;the history of miscarriage was higher in the well-controlled group than in the normal group;and the family history of hypertension was more than in the normal group.The difference between the two groups was not statistically significant(P > 0.05).2.Comparison of pregnancy outcomes: comparison between the three groups showed that the disparity in the preterm rupture of the fetal membranes(P = 0.006),fetal distress(P < 0.001),pre-eclampsia(P = 0.001)and preterm delivery(P = 0.012)were statistically significant,while the differences in the birth weight of the huge babies and newborns were not statistically significant(P > 0.05).The incidence of fetal distress in the group with good glycemic control was higher than that in the group with normal blood glucose;the incidence of preeclampsia and preterm delivery in the group with poor glycemic control was higher than that in the group with normal blood glucose according to the Bonferroni-adjusted alpha level(P < 0.0167).3.Logistic regression model analysis after adjusting for confounding factors revealed that poor glycemic control(OR: 2.265,95% CI: 1.237-4.147,P = 0.008)was an independent risk factor for premature rupture of membranes;good glycemic control(OR:3.926,95% CI: 1.913-8.058,P < 0.001)was an independent risk factor for fetal distress.independent risk factor for fetal distress.Conclusion:Poor glycemic control in pregnant women with gestational diabetes increases the incidence of premature rupture of membranes,pre-eclampsia and preterm delivery,while good glycemic control increases the incidence of fetal distress.logistic regression shows that poor glycemic control is an independent risk factor for premature rupture of membranes,Well-controlled blood glucose is an independent risk factor for fetal distress.Strict glycemic control during pregnancy should be used to reduce the occurrence of adverse pregnancy outcomes.