Development of a New Risk Score for Stratification of Women with Gestational Diabetes Mellitus at High Risk of Persisting Postpartum Glucose Intolerance Using Routinely Assessed Parameters
| Autor: | Silvie Sebestova, Veronika Ťápalová, Vendula Bartáková, Petr Janků, Lukáš Pácal, Beáta Barátová, Kateřina Kaňková |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
persisting glucose intolerance postpartum Science 030209 endocrinology & metabolism risk score Article General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Diabetes mellitus medicine Family history Ecology Evolution Behavior and Systematics 030219 obstetrics & reproductive medicine Framingham Risk Score Obstetrics business.industry Incidence (epidemiology) nutritional and metabolic diseases Paleontology Odds ratio medicine.disease Obesity gestational diabetes mellitus 3. Good health Gestational diabetes Space and Planetary Science Cohort lipids (amino acids peptides and proteins) peripartal outcomes business |
| Zdroj: | Life, Vol 11, Iss 464, p 464 (2021) Life Volume 11 Issue 6 |
| ISSN: | 2075-1729 |
| Popis: | The aims of the study were (i) to find predictive factors for early postpartum conversion of gestational diabetes mellitus (GDM) into persisting glucose intolerance (PGI), (ii) to evaluate potential differences in adverse perinatal outcomes in GDM women with and without early postpartum PGI and, finally, (iii) to establish a risk score to predict postpartum PGI. A cross-sectional study comprised 244 GDM patients with known age, parity, positive family history of diabetes, pre-gestational BMI, comorbidities, smoking history, results of mid-trimester oral glucose tolerance test, HbA1c, obstetric complications, neonatal outcomes and mode of delivery. A risk score was calculated using parameters with highest odds ratios in a statistic scoring model. Significant differences between women with and without PGI postpartum were ascertained for mid-trimester fasting plasma glucose (p < 0.001), HbA1c above 42 mmol/mol (p = 0.035), prevalence of obesity (p = 0.007), hypothyroidism, family history of diabetes and smoking. We also observed higher incidence of prolonged and complicated delivery in PGI group (p = 0.04 and 0.007, respectively). In conclusion, this study identified several parameters with predictive potential for early PGI and also adverse peripartal outcomes. We established a simple risk-stratification score for PGI prediction applicable for GDM affected women prior their leaving maternity ward. Yet, given a relatively small sample size as a main limitation of this study, the proposed score should be validated in the larger cohort. |
| Databáze: | OpenAIRE |
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