Background: Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.
Methods: The 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.
Results: The 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, χ2 = 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).
Conclusions: Management of GDM in the real world of clinical practice was unsatisfactory, which might have contributed to adverse pregnancy outcomes.
妊娠期糖尿病患者不理想的血糖管理及不良妊娠结局摘要背景：近年来，妊娠期糖尿病（GDM）的发病率不断增长，本文的目的是探讨GDM的管理及其与不良妊娠结局的关系。 方法：本研究收集了996例于2011-2015年在山东省立医院终止妊娠的GDM患者的数据，并对GDM治疗方案及分娩前入院情况进行了回顾性分析，并选择同时期年龄匹配的996例非糖尿病患者作为对照组，比较两组的妊娠结局。同时以Logistic回归分析评价空腹血糖（FPG）水平与不良妊娠结局之间的关系。 结果：5年间GDM平均患病率为4.4% (1330/30,191)。42.8% (426/996)妊娠期糖尿病患者接受饮食干预，19.1% (190/996)接受胰岛素治疗。血糖控制不良的GDM患者比对照组更易发生各种不良妊娠结局，如新生儿呼吸窘迫综合征（P＜0.01）。升高的血糖水平是早产(OR=1.460, P<0.001)、新生儿呼吸窘迫综合征(OR=1.322, P=0.001)、死胎(OR=1.427, P<0.001)等不良妊娠结局的一个独立的危险因素。 结论：妊娠期糖尿病患者在临床实践中的不完善管理，可能是导致妊娠糖尿病患者发生不良妊娠结局的重要原因。.
Keywords: Blood Glucose; Disease Management; Gestational Diabetes Mellitus; Pregnancy Outcome; Risk Factors.