Clinical analysis of screening for gestational diabetes mellitus in 945 pregnant women with 50 g glucose challenge test / 中华全科医师杂志

ABSTRACT

Objective To explore the clinical characteristics of gestational diabetes mellitus (GDM) and its relevant factors.Methods Using two diagnostic criteria set by World Health Organization and Carpenter/Coustan respectively, clinical data of 945 pregnant women who underwent glucose challenge test (GCT) in the Department of Obstetrics and Gynecology of China-Japan Friendship Hospital in Beijing during the past year were retrospectively analyzed.Results Of 945 pregnant women, 338 (35.8%) had 1 h serum glucose level equal to or greater than 7.8 mmol/L(140 mg/dl).Of these 338 women with positive GCT, 228 underwent 75 g oral glucose tolerance test (OGTT) and 102 (44.7%) of 228 were diagnosed as GDM. Women with GDM diagnosed according to either criteria had older age, higher body mass index(BMI) before pregnancy, more weight gain during the first 15 weeks of gestation, higher fasting blood glucose in early pregnancy and higher proportion of those with history of diabetes in their first-degree relatives than those with negative GCT. OGTT for pregnant women at about 30 weeks of gestation showed that insulin sensitivity decreased significantly in those with GDM compared with that in those with normal glucose tolerance, and the peak of insulin secretion delayed significantly in women with GDM.Logistic regression analysis showed that older age, higher BMI before pregnancy, more weight gain in early pregnancy and higher fasting blood glucose in early pregnancy were all independently associated with increased incidence of GDM.Conclusions Older age, higher BMI before pregnancy,more weight gain in early pregnancy,higher fasting blood glucose in early pregnancy,higher proportion of those with history of diabetes in their first-degree relatives and more severe insulin resistance were found in pregnant women with GDM than in those without GDM. It is suggested that those pregnant women with risk factors of GDM should be screened by fasting blood glucose in early pregnancy in order to be diagnosed and treated earlier.