Unsatisfactory Glucose Management and Adverse Pregnancy Outcomes of Gestational Diabetes Mellitus in the Real World of Clinical Practice: A Retrospective Study.

Ru Feng; Lu Liu; Yuan-yuan Zhang; Zhong-shang Yuan; Ling Gao; Chang-ting Zuo

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Unsatisfactory Glucose Management and Adverse Pregnancy Outcomes of Gestational Diabetes Mellitus in the Real World of Clinical Practice: A Retrospective Study.

Author: Ru FENG ^{1
,

2
,

3} ; Lu LIU ^{1
,

2
,

3} ; Yuan-Yuan ZHANG ⁴ ; Zhong-Shang YUAN ⁵ ; Ling GAO ^{6
,

7} ; Chang-Ting ZUO ⁴
Author Information

1. Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University
2. Shandong Clinical Medical Center of Endocrinology and Metabolism
3. Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China.
4. Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China.
5. Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong 250012, China.
6. Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China
7. Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China.
Publication Type:Journal Article
Keywords: Blood Glucose; Disease Management; Gestational Diabetes Mellitus; Pregnancy Outcome; Risk Factors
MeSH: Blood Glucose; analysis; Diabetes, Gestational; blood; Female; Humans; Pregnancy; Pregnancy Complications; blood; Pregnancy Outcome; Retrospective Studies; Risk Factors
From: Chinese Medical Journal 2018;131(9):1079-1085
CountryChina
Language:English
Abstract:
BackgroundFacing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.
MethodsThe data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age. The association between fasting plasma glucose (FPG) and adverse pregnancy outcomes was examined by logistic regression analyses.
ResultsThe average prevalence of GDM over the 5 years was 4.4% (1330/30,191). Within the GDM patients, 42.8% (426/996) received dietary intervention, whereas 19.1% (190/996) received insulin treatment. Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome (RDS, χ = 13.373, P < 0.01). Elevated FPG was identified as an independent risk factor for premature birth (odds ratio [OR] = 1.460, P < 0.001), neonatal care unit admission (OR = 1.284, P < 0.001), RDS (OR = 1.322, P = 0.001), and stillbirth (OR = 1.427, P < 0.001).
ConclusionsManagement of GDM in the real world of clinical practice was unsatisfactory, which might have contributed to adverse pregnancy outcomes.