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ORIGINAL RESEARCH article

Front. Med.
Sec. Obstetrics and Gynecology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1453503

Analysis of the effects of GDM based on abnormal blood glucose on perinatal outcomes in primiparous women of advanced age

Provisionally accepted
Jiahui Tu Jiahui Tu 1Chanyun Xiao Chanyun Xiao 1Shasha Liu Shasha Liu 1Miao Cheng Miao Cheng 1Siqiao Ge Siqiao Ge 1Yulin Liu Yulin Liu 2Hong Yang Hong Yang 1*
  • 1 Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 2 Yunyang District Maternal and Child Health Hospital, Shiyan, China

The final, formatted version of the article will be published soon.

    Background Gestational diabetes mellitus (GDM) impairs to a varying degree the risk for maternal and perinatal morbidity. This study was designed to determine whether the outcome heterogeneity was related to the number of abnormal maternal glucose measurements of the oral glucose tolerance test. Methods The retrospective study enrolled 1109 eligible pregnant women treated between June 2020 and December 2023. According to the glucose levels from the 2-h 75 g-OGTT at 24–28 weeks of gestation, these primiparous women of advanced age were classified into four groups: GDM group A (one abnormal OGTT value, n=361), GDM group B (two abnormal OGTT values, n=106), GDM group C (three abnormal OGTT values, n=58), and non-GDM group (no abnormal OGTT value, n=584). Data on general characteristics, obstetric outcomes, and neonatal variables were collected. The risk of each adverse outcome was analyzed using a multivariate logistic regression model, with P<0.05 considered statistically significant. Results The analysis of general characteristics demonstrated significant differences in pre-pregnancy weight, pre-pregnancy body mass index, and gestational weight gain (GWG) among the four groups (all P<0.05). The risk for neonatal hypoglycemia and neonatal intensive care unit (NICU) transfer increased with the number of abnormal OGTT values (adjusted odds ratio [OR]: 2.40, 95% confidence interval [CI]: 1.80–3.21, P<0.01; adjusted OR: 1.65, 95% CI: 1.33–2.03, P<0.01; respectively). Conclusion Although GDM, based on abnormal blood glucose levels, did not significantly affect adverse obstetric outcomes in primiparous women of advanced age, the number of abnormal OGTT values was an independent risk factor for neonatal hypoglycemia and NICU transfer. Stratified GDM management should be considered according to the profile of abnormal maternal glucose responses to the OGTT. Patient testing burden and costs might be reduced by protocols that tailor the clinical management according to the number and pattern of abnormal values of the OGTT.

    Keywords: Gestational diabetes mellitus (GDM), Primiparous women of advanced age, Abnormal blood glucose, Oral glucose tolerance test (OGTT), adverse perinatal outcomes

    Received: 23 Jun 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Tu, Xiao, Liu, Cheng, Ge, Liu and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hong Yang, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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