Qiuhong Zhang1,2, Chee Shin Lee1, Lixia Zhang1, Qi Wu1, Yunyan Chen1,3, Danqing Chen1, Lu Qi4, Zhaoxia Liang1,4. 1. Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 2. Nanxun District People's Hospital, Huzhou, China. 3. Huzhou Women and Children's Hospital, Huzhou, China. 4. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.
Abstract
Background: To investigate the influence of HbA1c level and GWG on pregnancy outcomes in pregnant women with GDM. Methods: A total of 2,171 pregnant women with GDM were retrospectively included and categorized as follows: (1) normal (HbA1c <6%) and elevated (HbA1c ≥6%) HbA1c groups according to the HbA1c level in the second trimester, and (2) inadequate, appropriate, and excessive GWG groups according to the IOM guidelines. Results: In pregnant women with GDM, advanced age and high pre-pregnancy BMI were high-risk factors for elevated HbA1c. Pregnant women with elevated HbA1c had higher OGTT levels than those with normal HbA1c, and the risks of adverse pregnancy outcomes were higher (P < 0.05). The risks of primary cesarean section, hypertensive disorders during pregnancy, and macrosomia in pregnant women with excessive GWG were significantly higher than those with inadequate and appropriate GWG (P < 0.05). When GWG was appropriate, the risk of hypertensive disorders during pregnancy in the elevated HbA1c group was higher than that in the normal HbA1c group. When GWG was excessive, the risks of postpartum hemorrhage, macrosomia, and neonatal asphyxia in the elevated HbA1c group were significantly higher than in the normal HbA1c group (P < 0.05). Conclusion: Monitoring and controlling blood glucose levels have shown effectiveness in reducing the adverse pregnancy outcomes in women with GDM, particularly for those who had excessive GWG.
Background: To investigate the influence of HbA1c level and GWG on pregnancy outcomes in pregnant women with GDM. Methods: A total of 2,171 pregnant women with GDM were retrospectively included and categorized as follows: (1) normal (HbA1c <6%) and elevated (HbA1c ≥6%) HbA1c groups according to the HbA1c level in the second trimester, and (2) inadequate, appropriate, and excessive GWG groups according to the IOM guidelines. Results: In pregnant women with GDM, advanced age and high pre-pregnancy BMI were high-risk factors for elevated HbA1c. Pregnant women with elevated HbA1c had higher OGTT levels than those with normal HbA1c, and the risks of adverse pregnancy outcomes were higher (P < 0.05). The risks of primary cesarean section, hypertensive disorders during pregnancy, and macrosomia in pregnant women with excessive GWG were significantly higher than those with inadequate and appropriate GWG (P < 0.05). When GWG was appropriate, the risk of hypertensive disorders during pregnancy in the elevated HbA1c group was higher than that in the normal HbA1c group. When GWG was excessive, the risks of postpartum hemorrhage, macrosomia, and neonatal asphyxia in the elevated HbA1c group were significantly higher than in the normal HbA1c group (P < 0.05). Conclusion: Monitoring and controlling blood glucose levels have shown effectiveness in reducing the adverse pregnancy outcomes in women with GDM, particularly for those who had excessive GWG.
Authors: Arianne N Sweeting; Glynis P Ross; Jon Hyett; Lynda Molyneaux; Kris Tan; Maria Constantino; Anna Jane Harding; Jencia Wong Journal: J Clin Endocrinol Metab Date: 2017-01-01 Impact factor: 5.958
Authors: Ravi Retnakaran; Ying Qi; Philip W Connelly; Mathew Sermer; Bernard Zinman; Anthony J G Hanley Journal: J Clin Endocrinol Metab Date: 2009-11-19 Impact factor: 5.958
Authors: Rebecca F Goldstein; Sally K Abell; Sanjeeva Ranasinha; Marie Misso; Jacqueline A Boyle; Mary Helen Black; Nan Li; Gang Hu; Francesco Corrado; Line Rode; Young Ju Kim; Margaretha Haugen; Won O Song; Min Hyoung Kim; Annick Bogaerts; Roland Devlieger; Judith H Chung; Helena J Teede Journal: JAMA Date: 2017-06-06 Impact factor: 56.272