Gestational diabetes mellitus in early pregnancy amongst Asian Indian women: Evidence for poor pregnancy outcomes despite treatment.

Autor: Punnose J; Department of Endocrinology, St. Stephen's Hospital, Delhi, India., Malhotra RK; AIIMS, Delhi, India., Sukhija K; Department of Endocrinology, St. Stephen's Hospital, Delhi, India., M RR; Department of Endocrinology, St. Stephen's Hospital, Delhi, India., Choudhary N; Department of Obstetrics and Gynecology, St. Stephen's Hospital, Delhi, India., Sharma A; Department of Obstetrics and Gynecology, St. Stephen's Hospital, Delhi, India., Vij P; Department of Reproductive Medicine, St. Stephen's Hospital, Delhi, India., Bahl P; Department of Paediatrics and Neonatology, St. Stephen's hospital, Delhi, India.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2023 Jan; Vol. 40 (1), pp. e14993. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1111/dme.14993
Abstrakt: Aim: To compare the pregnancy outcomes in women with gestational diabetes (GDM) based on the timing of diagnosis.
Methods: This retrospective cohort study was conducted between January 2011 and September 2017 amongst 2638 Asian Indian pregnant women. The inclusion criteria included; singleton pregnancies having HbA1c <48 mmols/mol (6.5%) in the first trimester, GDM screening by 75 g OGTT using IADPSG criteria and delivery at our centre. The cohort was divided into 3 groups: Early GDM (E-GDM)-diagnosis <24 gestational weeks (Gw), Standard GDM (S-GDM)-diagnosis ≥24Gw, Non-GDM- No GDM ≥24 Gw. Multivariable logistic regression models compared the pregnancy outcomes between Non-GDM, S-GDM and E-GDM groups. A sub-group multivariable analysis was done amongst GDM women using gestational age at diagnosis both as a categorical and continuous variable.
Results: Compared to Non-GDM women, the odds were higher for premature birth, large for gestational age (LGA) babies, macrosomia, Neonatal ICU(NICU) admission and lower for normal vaginal delivery in the E-GDM group, but for the S-GDM group, the risk was higher for premature birth, LGA babies, NICU admission and induction of labour. Compared to GDM women in the 24-28 Gw category significantly higher odds for premature birth and LGA babies were observed in the <14 Gw category. A continuous increase of 19% odds for premature birth with every 4 weeks decrease in gestational age at GDM diagnosis was observed.
Conclusions: Asian Indian women having a GDM diagnosis before 24Gw are at higher risk for adverse pregnancy events than those having diagnosis ≥24Gw or not having GDM.
(© 2022 Diabetes UK.)
Databáze: MEDLINE
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