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Evaluating the Impact of Gestational Diabetes Mellitus with Different Glucose Abnormalities on Perinatal Outcomes among Primiparous Women of Advanced Age

obstetrics-and-gynecology
diabetes

Abstract

Background: Gestational diabetes mellitus (GDM) could have a variable degree of adverse effects on perinatal outcomes . This research aimed to investigate whether variability in p erinatal outcomes correlates with the quantity of abnormal glucose levels detecting by OGTT. Methods: This retrospective analysis included 1109 eligible women who received antenatal care between Jun2020 and Dec2023. Participants were stratified into four groups based on 75g OGTT at 24-28 gestational weeks: GDM group A (single abnormal value, n=361), GDM group B (dual abnormalities, n=106), GDM group C (triple abnormalities, n=58), and non-GDM group (normal values, n=584). Researchers collected demographic and clinical parameters alongside detailed obstetric and neonatal outcomes. Adverse event risks were assessed through multivariate logistic regression analyses adjusted for potential confounders, with statistical significance defined as P<0.05. Results: The investigation of baseline characteristics revealed statistically significant variations in pre-pregnancy weight , pre-pregnancy BMI, and total weight gained during pregnancy across the four groups (all P<0.05). Notably, the likelihood of infants developing hypoglycemia showed a positive correlation with the quantity of abnormal OGTT results, with adjusted odds ratios reaching 2.40 (95% CI:1.80-3.21, P<0.01). Concurrently, the probability of admission to neonatal intensive care units (NICU) demonstrated a similar upward trend, exhibiting an adjusted OR of 1.65 (95% CI:1.33-2.03, P<0.01) for each additional abnormal OGTT parameter. Conclusions: The quantity of abnormal OGTT result emerged as an independent predictor for both neonatal hypoglycemia and NICU admission. Tailored gestational diabetes management strategies should be developed based on distinct patterns of maternal glycemic dysregulation observed in OGTT profiles.
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