Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review

Mistry, Sabuj Kanti; Gupta, Rajat Das; Alam, Sabiha; Kaur, Kuljeet; Shamim, Abu Ahmed; Puthussery, Shuby

doi:10.1002/edm2.285

Cited by 49 publications

(38 citation statements)

References 46 publications

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“…There is sufficient evidence that hyperglycemia during pregnancy can increase the risk of adverse pregnancy outcomes in mothers and their offspring in both the short and long term compared with normal pregnant women ( 1 ). A recent systematic review in South Asia showed that GDM is positively correlated with the occurrence of preeclampsia and has an impact on the occurrence of macrosomia, neonatal hyperglycemia, intrauterine growth retardation, stillbirth, and low birth weight ( 21 ). Some studies on LGA in China have shown that the incidence of LGA in patients with GDM ranges from 10–47.3% ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

Yu¹,

Liu²,

Wu³

2023

Ann Transl Med

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Background Blood glucose variability (GV) is believed to be closely related to the occurrence of adverse obstetric outcomes. However, few studies have investigated how the change in fasting plasma glucose (FPG) influenced on the adverse obstetric outcomes. This study mainly evaluated the relationship between FPG coefficient of variation (FPG-CV) and adverse outcomes in patients with gestational hyperglycemia and determine the ideal FPG-CV threshold for predicting maternal and infant outcomes. Methods We retrospective analyzed the data of 608 pregnant hyperglycemic patients in the Obstetrics Department of Shengjing Hospital Affiliated to China Medical University between June 2019 and December 2021 and followed up inpatients through the Hospital Information System (HIS). We collected the venous FPG from 24–28 weeks of pregnancy to delivery. Maternal and infant outcomes were based on the latest definitions. The chi-square test and logistic regression analysis were performed to evaluate the correlation between FPG-CV and adverse outcomes. Two multivariate binary logistic regression models were used to adjust for confounding factors. Stratified analysis was performed according to hemoglobin A1c (HbA1c) levels (<5.9% and ≥5.9%) and insulin injection (not used and used) in the third trimester of pregnancy. The receiver operating characteristic (ROC) curve was used to evaluate the prediction of FPG-CV on adverse outcomes. Results All patients were divided into four groups based on the quartile of FPG-CV. The proportion of FPG-SD and insulin injections differed among the groups (P<0.05). Among the outcomes, the highest incidence rate was 26.3% for large for gestational age (LGA), 8.7% for premature delivery. FPG-CV remains independently associated with low birth weight [odds ratio (OR) =1.086, P=0.007], preterm birth (OR =1.069, P=0.012), and preeclampsia (OR =1.180, P<0.001). FPG-CV can predict preeclampsia, with an area under the curve (AUC) of 0.725. Conclusions Our results suggest that patients with gestational hyperglycemia should undergo routine FPG monitoring from diagnosis to delivery. Also, the impact of blood glucose fluctuations on adverse outcomes should be considered in the clinical treatment. The rational application of hypoglycemic treatment can stabilize blood glucose levels, however, the effects of different regimens on GV and outcomes should be studied further.

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Section: Discussionmentioning

confidence: 99%

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

Yu¹,

Liu²,

Wu³

2023

Ann Transl Med

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“…Nowadays, with the improvement of people's living standards and the development of medical technology, the incidence of GDM is getting higher and higher [ 3 ]. If GDM is not treated in time, it is very detrimental to the health of pregnant women and fetuses [ 4 – 6 ]. For pregnant women, GDM can increase the mother's possibility of developing high blood glucose, high blood pressure, and preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Effects of Early Nursing Monitoring on Pregnancy Outcomes of Pregnant Women with Gestational Diabetes Mellitus under Internet of Things

Huang

2022

Computational and Mathematical Methods in Medicine

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To analyze the effect of early nursing intervention based on fetal heart signal extraction algorithm and Internet of Things (IoT) wireless communication technology on the adverse pregnancy outcomes of pregnant women with gestational diabetes mellitus (GDM) and newborns, 88 pregnant women diagnosed with GDM who underwent the 75 g glucose tolerance test at 24-28 gestational weeks in the hospital were selected as the research objects. According to the different intervention methods, the patients were divided into 44 cases of the experimental group (nursing intervention based on maternal and infant monitoring system) and 44 cases of the control group (outpatient follow-up intervention). The results showed that the compliance score and diet compliance rate of patients in the experimental group were signally higher than those in the control group at 1 and 3 months after intervention ( P < 0.05 ). The levels of fasting blood glucose (FBG), blood glucose 2 hours after the meal, and hemoglobin A1c (HbA1c) in the experimental group were lower than those in the control group at 1 and 3 months after intervention ( P < 0.05 ). The number of giant babies, hypoglycemia, hyperbilirubinemia, fetal distress, premature delivery, and birth weight in the experimental group was all lower than those in the control group, while the Apgar scores were higher than that in the control group ( P < 0.05 ). To sum up, the intervention based on the intelligent maternal and infant monitoring system could timely help pregnant women adjust their diet structure and optimize the management of blood glucose and blood lipids, thus effectively improving the adverse pregnancy outcome and maintaining the health of pregnant women and newborns.

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“…The risk of developing PE in patients with GDM has been, up to date, widely studied [ 22 , 23 , 24 , 25 ]. PE and GDM share several risk factors, such as advanced maternal age, nulliparity, multiple pregnancy, ethnicity, and pregestational obesity.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Coexisting Gestational Diabetes Mellitus on the Course of Preeclampsia

Pankiewicz¹,

Szczerba²,

Fijałkowska³

et al. 2022

JCM

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A strict correlation between gestational diabetes mellitus (GDM) and preeclampsia (PE) has been shown in previous studies. This case-control observational study evaluates the influence of concomitant GDM on the severity of PE. Ninety-nine patients were included: thirty-eight with PE without GDM (group 1), fourteen with PE and concomitant GDM (group 2), and forty-seven with uncomplicated pregnancies (group 3). Adverse maternal/fetal and neonatal outcomes were registered. Patients underwent blood sample analysis of serum PlGF, sFlt-1, creatinine levels, and platelet count (PLT). The incidence of preterm birth, FGR, HELLP syndrome, and NICU admission was significantly higher in group 1 in comparison to groups 2 and 3, whereas RDS was diagnosed most often in group 2 in comparison to groups 1 and 3. All studied biochemical parameters differed between the control group and both PE groups; however, there were no differences between patients with PE with and without GDM. The presented study indicates that the coexistence of GDM may mitigate the course of PE. The lack of differences between patients with PE with and without GDM in serum levels of studied biomarkers may also confirm its usefulness in the diagnosis and management of PE in patients with coexisting GDM.

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Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 49 publications

References 46 publications

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

Effects of Early Nursing Monitoring on Pregnancy Outcomes of Pregnant Women with Gestational Diabetes Mellitus under Internet of Things

The Impact of Coexisting Gestational Diabetes Mellitus on the Course of Preeclampsia

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