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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 57-61    DOI: 10.31083/j.ceog.2020.01.4998
Original Research Previous articles | Next articles
Importance of diagnosis time on pregnancy outcomes in pregnant women with pre-gestational diabetes mellitus
Hongying Zhang1, *(), Qingling Wei2, Jinlan Wei2, Haiyang Pang3, Wenxuan Wei1, Yu Sun1, Mengya He1, Yanling Sun1
1Department of Obstetrics, Yidu Central Hospital of Weifang, Shandong, China
2Department of Public Health, Yidu Central Hospital of Weifang, Shandong, China
3Department of Rehabilitation Medicine, Pingdu Peoples's Hospital, Shandong, China
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Abstract  

Objective: To analyze the characteristics of pregnant women with pre-gestational diabetes mellitus (PGDM) who had missed diagnosis prior to pregnancy, and to evaluate the effects of diagnosis time on pregnancy outcomes in pregnant women with PGDM. Materials and Methods: A total of 822 pregnant women who were diagnosed with PGDM were conducted in this study. They were divided into two groups, including pre-pregnancy diagnosis group and pregnancy diagnosis group based on the initial diagnosis time. Then in the pregnancy diagnosis group, the cases diagnosed before 24 gestational weeks were defined as group A, and those diagnosed at or after 24 gestational weeks were defined as Group B. Maternal and pregnancy variables, as well as pregnancy outcomes, including delivery age of pregnant women, the rate of pregnancy loss, delivery gestational weeks, neonatal birth weight, the proportion of insulin treatment, the rate of pre-term, macrosomia, newborns transferred to pediatrics, the average of HbA1c level, and preeclampsia, were analyzed among groups by paired Student’s t-test. Results: The rate of missed diagnosis before pregnancy was 68.1%. The proportion of insulin treatment and the rate of the cesarean section had a significant difference between pre-pregnancy diagnosis group and pregnancy diagnosis group. The characteristics and pregnancy outcomes in pregnancy diagnosis group A were not significantly different from those in the pre-pregnancy diagnosis group. However, in the pregnancy diagnosis group B, the proportion of pregnant women using insulin treatment and the average HbA1c level had a statistically significant difference, compared to pregnancy diagnosis group A, as well as the pre-pregnancy group. Conclusions: The rate of undiagnosed PGDM was high, and PGDM was significantly associated with multiple adverse pregnancy outcomes. Fasting plasma glucose should be used as a screening test to identify PGDM at pre-pregnancy or first antenatal care.

Key words:  Pre-gestational diabetes mellitus      Pregnancy outcome      Diagnosis time     
Published:  15 February 2020     
*Corresponding Author(s):  Hongying Zhang     E-mail:  hongying_zhang12@163.com

Cite this article: 

Hongying Zhang, Qingling Wei, Jinlan Wei, Haiyang Pang, Wenxuan Wei, Yu Sun, Mengya He, Yanling Sun. Importance of diagnosis time on pregnancy outcomes in pregnant women with pre-gestational diabetes mellitus. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 57-61.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.01.4998     OR     https://ceog.imrpress.com/EN/Y2020/V47/I1/57

Table 1  — Comparison of characteristics of PGDM pregnant women in the different groups.
Variables PGDM groups p1 p2 p3 p4
PPD
(n = 262)
PD (n =560)
A (n = 107) B (n = 453)
Pregnancy loss 57 (21.8) 26 (25.7) 74 (16.3) 0.185 0.595 0.071 0.053
Delivery age (years) 32 ± 5 32 ± 4 33 ± 4 0.672 0.424 0.371 0.415
DGW (weeks) 38.5 ± 1.8 38.1 ± 1.7 38.3 ± 1.6 0.085 0.066 0.157 0.305
NBW (g) 3377 ± 422 3308 ± 415 3390 ± 387 0.060 0.152 0.667 0.051
Table 2  — Comparison of blood glucose control and pregnancy outcomes of PGDM pregnant women in the different groups.
Therapy and Outcomes Cases
(n = 822)
PGDM groups p1 p2 p3 p4
PPD
(n = 262)
PD (n =560)
A (n = 107) B (n = 453)
Insulin treatment < 0.001 0.207 < 0.001 < 0.001
No 286 27 16 243
Yes 536 235 91 210
Term 0.460 0.823 0.422 0.731
Full-term 672 218 88 366
Pre-term 150 44 19 87
Cesarean < 0.001 0.060 < 0.001 0.486
No 298 72 40 186
Yes 524 190 67 267
Macrosomia 0.535 0.801 0.513 0.835
No 752 242 98 412
Yes 70 20 9 41
NTP 0.826 0.897 0.828 0.986
No 544 172 71 301
Yes 278 90 36 152
Preeclampsia 0.854 0.682 0.938 0.704
No 752 239 99 414
Yes 70 23 8 39
HbA1c (%) 6.3 ± 1.1 6.4 ± 1.3 6.0 ± 1.3 0.091 0.263 0.005 0.002
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