Association between fasting plasma glucose in early pregnancy and diagnosis of gestational diabetes mellitus / 中华围产医学杂志

ABSTRACT

Objective To explore the relevance between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM). Methods Clinical data of 5299 singletonpregnant women accepted antenatal examination and delivered in the Department of Obstetrics and Gynecology, Peking University First Hospital from January 1, 2008 to December 31, 2009 were retrospectively analyzed. Results (1) The pregnant women were divided into 3 groups according to their FPG levels at early stage of gestation Group A, FPG ＜5. 1 mmol/L (n= 4565); Group B,FPG≥5.1, but ＜5.8 mmol/L (n=701); Group C, FPG≥5.8 mmol/L, but ＜7.0 mmol/L(n=33). The incidence of GDM in Group A, B and C was 10. 69% (488/4565), 26. 11% (183/701)and 54. 55% (18/33). (2) The incidences of large for gestational age (LGA), cesarean section,premature birth, preeclampsia, neonatal hyperbilirubinemia, neonatal hypoglycemia, neonatal polycythemia, and neonatal infection were compared between Group A and B. The cesarean section rate [54. 63% (282/518)]and neonatal hypoglycemia rate [1.54% (8/518)]of those who were not diagnosed as GDM in middle and late term in Group B were higher than those of Group A [49.03%(1999/4077) and 0. 61% (25/4077)] (P＜0. 05); while there were no differences between the other six index of Group A and Group B (P＞0. 05). The prognosis of the GDM patients who did not accept gestational glucose management in two groups were similar (P＞0. 05), so did the prognosis of the GDM patients who accepted gestational glucose management in two groups. After combining the patients of the two groups who were not diagnosed as GDM as a new group, they were compared with those who did not accept gestational glucose management of the two groups (Group A2 and B2)respectively. The incidence of LGA rate of the new group was lower than that of Group A2 (12. 00%va 4. 94 %, x2=21. 4159, P＜0. 05) and Group B2 (18. 39 % vs 4. 94%, x2 = 28. 7189, P＜0. 05).Cesarean section rate of the new group was lower than that of Group A2 (57. 78% vs 49.64%,x2 =5. 6806,P＜0.05) and Group B2 (66. 67% vs 49.64%, x2 =9. 9003, P＜0. 05). And there were no differences between the other six index between the new group and the other two groups (P＞0. 05). Conclusions The diagnosis criteria of GDM set as FPG≥5.1 mmol/L at early stage of gestation, recommended by International Association of Diabetes and Pregnancy Study Group, is not applicable in China yet. Oral glucose tolerance test in middle and late term is still the most important diagnostic tool for GDM.