Clinical analysis of 2860 cases of diabetes in pregnancy: a single-center retrospective study

Abstract

Background To investigate the epidemiological, clinical characteristics and outcomes of diabetes in pregnancy (DIP). Methods This single-center, retrospective study included 16,974 pregnant women hospitalized during 2018–2019. Among them, 2860 DIP patients were grouped according to diabetes type, glycemic status, and insulin use. Multivariate logistic regression analysis was conducted. Results The incidence of DIP [17.10%; pregestational diabetes mellitus (PGDM), 2.00% (type I, 0.08%; type 2, 1.92%); gestational diabetes mellitus (GDM), 14.85% (GDM A1, 13.58%; GDM A2, 1.27%)] increased annually. Premature birth, congenital anomalies, large for gestational age (LGA), neonatal asphyxia, neonatal intensive care unit transfer, hypertension, and puerperal infection were more common in DIP than in healthy pregnancies. The most common comorbidities/complications were hypertension, thyroid dysfunction, cervical incompetence, intrahepatic cholestasis, premature membrane rupture, oligo/polyhydramnios, and fetal distress. GDM incidence at ages ≥35 and ≥ 45 years was 1.91 and 3.26 times that at age < 35 years, respectively. If only women with high-risk factors were screened, 34.8% GDM cases would be missed. The proportion of insulin use was 14.06% (PGDM, 55%; GDM, 8.53%). Mean gestational age at peak insulin dose in DIP was 32.87 ± 5.46 weeks. Peak insulin doses in PGDM and GDM were 3.67 and 2 times the initial doses, respectively. The risks of LGA, premature birth, cesarean section, and neonatal hypoglycemia in PGDM were 1.845, 1.533, 1.797, and 1.368 times of those in GDM, respectively. The risks of premature birth and neonatal hypoglycemia in women with poor glycemic control were 1.504 and 1.558 times of those in women with good control, respectively. Conclusions The incidence of adverse outcomes in DIP is high.

Obstetric ultrasonography as a screening tool for the diagnosis of GDM: Detection of raised AFI and large for gestational age fetus

“…But, if only women with risk factors for GDM are screened, the proportion of missed diagnosis will be very high leading to extraordinary complication rate. 23,24 Our study documented a strong relationship of increased AFI and LGA fetuses with GDM. Considering easy accessibility, frequent and common use of ultrasound; we suggest (after further studies and multicenter trials) the inclusion of these ultrasound parameters as routine screening tools for detection of GDM in second half of pregnancy in undiagnosed cases.…”

Secular increase in the prevalence of gestational diabetes and its associated adverse pregnancy outcomes from 2014 to 2021 in Hebei province, China

“…Abnormal lipid metabolism in patients with hypertension can easily be complicated by abnormal glucose metabolism. Previous studies have shown that gestational diabetes may be related to puerperal infection and Cesarean section incision infection ( 16 – 18 ). However, this study showed that the incidence of puerperal infection and Cesarean section infection in pregnant women with GDM was not different from that in the non-GDM group.…”