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1 Med J Chin PLA, Vol. 42, No. 1, January 1, [ ] 75g (OGTT) 214 2h 1h 226 (GDM) 235 OGTT 1h 2h (P<.1) (FGR) (P>.5) (P<.1) OGTT [ ] 75g [ ] R714.7 [ ] A [ ] (217) [DOI].11855/j.issn Correlation of reversely increased level of plasma glucose during pregnancy to the pregnancy outcome SHEN Xiao-ya, PAN Shi-lei *, CAI Wei, ZHU Bao-ping Department of Gynaecology and Obstetrics, Zhujiang Hospital of Southern Medical University, Guangzhou 5282, China * Corresponding author, panshilei81@163.com [Abstract] Objective To explore the correlation of the reversely increased results of 75g oral glucose tolerance test (OGTT) during pregnancy to the pregnancy outcome, so as to provide a reliable theoretical basis of the early intervention for the pregnant women with high plasma glucose. Methods The clinical data of 461 cases were retrospectively analyzed. Patients were chosen from the pregnant women undergoing routine antenatal examination in our hospital during 214. According to the results of 75g OGTT, 226 patients were analyzed as the observation group, in whom the level of postprandial 2-hour plasma glucose was higher than that of postprandial 1-hour plasma glucose. Meanwhile 235 pregnant women with or without gestational diabetes mellitus (GDM) were randomly selected as the control group. Results The levels of fasting plasma glucose and 1-hour postprandial plasma glucose were lower, but those of 2-hour postprandial plasma glucose was higher in observation group than in control group (P<.1). No statistical difference existed between the two groups (P>.5) in the incidences of polyhydramnios, oligohydramnios, fetal growth restriction (FGR), premature labor (PTL), pregnancy induced hypertension (PIH), complicated with premature rupture of membrane (PROM), intrauterine fetal death (IUFD) and non scar uterus cesarean section rate (CSR). Compared with the observation group, the rates of neonatal dysplasia and neonatal asphyxia and the newborn transfer rate were lower in the control group, of which the newborn transfer rate was statistically different (P<.1). Conclusions There might be a delayed plasma glucose metabolism in the patients with reversely increased result of 75g OGTT during pregnancy, which may affect the long-term prognosis of the newborn. Therefore, more attention should be paid to such patients with reversely increased result of 75g OGTT. [Key words] 75g oral glucose tolerance test; glucose metabolism disorders; pregnancy outcome [1] [ ] [ ] 5282 ( ) [ ] panshilei81@163.com 2 [2] (gestational diabetes mellitus GDM) [3-4] (oral glucose tolerance test

2 OGTT) GDM 3min 1~2h [5] OGTT 2h > 1h OGTT ( )226.47% ~43 1~7 1~ ~28 OGTT 8~14h 75g 2~3ml 5min 1 2h 2ml 2h > 1h GDM( 5.1~6.9mmol/L 1h.mmol/L 2h 8.5mmol/L) ( 7.mmol/L 11.1mmol/L) GDM SPSS 19. x±s t χ 2 P< (P>.5) 39.14± ± 1.53 (P<.5 1) 1 (x±s) Tab.1 Comparison of the general clinical data between the two groups (x±s) Group Age (year) Gravidity Parity Gestational weeks of terminate pregnancy (week) (n=226) 28.3± ± ± ± 1.19 (n=235) 28.62± ± ± ± 1.53 P value (P<.5) OGTT 1 2h (P<.1) 1h 1.4mmol/L 2h.8mmol/L 1~2h ( 1) (HbA 1c %) (P>.5 2) 2.3 (FGR) (P>.5 3) 2

3 Med J Chin PLA, Vol. 42, No. 1, January 1, Blood glucose (mmol/l) Number of cases FPG 1h 2h A Blood glucose (mmol/l) FPG 1hr 2hr Number of cases 1 (A) (B)OGTT Fig.1 OGTT results of observation group (A) and control group (B) B 2 (x±s) Tab.2 Comparison of the relevant indexes of blood glucose between the two groups (x±s) Group Blood glucose (mmol/l) HbA 1c (%) FBG Postprandial 1h plasma glucose Postprandial 2h plasma glucose Early pregnancy Late pregnancy (n=226) 4.484± ± ± ± ±.436 (n=235) 4.422± ± ± ± ±.336 P value FBG. Fasting blood glucose; HbA 1c.HemoglobinA 1c 3 [ (%)] Tab.3 Comparison of pregnancy outcome between the two groups [n(%)] Group (n=226) (n=235) P value Polyhydramnios 3(1.32) 2(.85).482 Oligohydramnios 15(6.64) 9(3.83).126 FGR 3(1.32) 2(.85).482 PTL 12(5.31) (4.26).595 PIH 7(3.) 5(2.13).513 PROM 6(26.55) 52(22.13).224 PPH 1(.44) 2(.85).515 CSR 73(32.3) 73(31.6).426 IUFD 2(.88) ().24 FGR. Fetal growth restriction; PTL. Preterm labor; PIH. Pregnancy induced hypertension; PROM. Premature rupture of membrane; PPH. Postpartum hemorrhage; CSR. Cesarean section rate; IUFD. Intrauterine fetal death (P>.5 2) Incidence of complications (%) Polyhydramnios Oligohydramnios FGR PTL PIH PROM CSR IUFD 2 Fig.2 Comparison of pregnancy complications between the two groups FGR. Fetal growth restriction; PTL. Preterm labor; PIH. Pregnancy induced hypertension; PROM. Premature rupture of membrane; CSR. Cesarean section rate; IUFD. Intrauterine fetal death

4 (P>.5) 3 3d 2 (P<.5 4) 4 [ (%)] Tab.4 Comparison of neonates related data between the two groups [n(%)] Item (n=226) (n=235) P value Birth weight (g) ± ± Male/Female (n) 118/ /8.668 Macrosomia [n(%)] 4(1.77) 4(1.7).616 MLBW [n(%)] 9(3.98) 9(3.82).933 CM [n(%)] (4.42) 6(2.55).272 Asphyxia [n(%)] 7(3.) 2(.85).79 Transferrate[n(%)] 42(18.58) 15(6.38). MLBW. Mature low birth weight; CM. Congenital malformation 3 OGTT [6-8] OGTT 2 [9] OGTT (P<.1) 2 1h 2h HbA 1c GDM 2 [] 3h [11] ( ) (P<.1) 5% GDM [1] Poomalar GK. Changing trends in management of gestational diabetes mellitus[ J]. World J Diabetes, 215, 6(2): [2] Yi HY, Yin MH. Analysis of related risk factors of gestational diabetes mellitus[ J]. Chin J Crit Care Med, 215, 35(Z1): [,. [J]., 215, 35(Z1): ] [3] Harreiter J, Dovjak G, Kautzky-Willer A. Gestational diabetes mellitus and cardiovascular risk after pregnancy[ J]. Womens Health (Lond). 214, (1): [4] Mayi NE, Yan LJ, Gu MN, et al. Observation on therapeutic effect and safety of Insulin aspart on the treatment of gestational diabetes mellitus with[ J]. J Logist Univ PAPF(Med Sci), 213, 22(8): [,,,. [J]. ( ), 213, 22(8): ] [5] Liao Eryuan. Endocrinology and metabolism[m]. People's Medical Publishing House, [. [M]. :, ] [6] Gao Q. Progress in the study of the relationship between gestational diabetes mellitus and metabolic syndrome[ J]. J Pract Obstet Gynecol, 214, 3(3): [.

5 Med J Chin PLA, Vol. 42, No. 1, January 1, [J]., 214, 3(3): ] [7] Chen X, Di SZ, Li C, et al. Effect of early peritoneal drainage on the injury of intestinal mucosa in the rats with severe acute pancreatitis[ J]. J Zhengzhou Univ(Med Sci), 215, 5(4): [,,,. [J]. ( ), 215, 5(4): ] [8] Fang FS, Cheng XL, Tian H, et al. Effect of fluctuation blood glucose level on arteriosclerosis in non-diabetic population[ J]. Med J Chin PLA, 213, 38(12): 3-6. [,,,. [J]., 213, 38(12): 3-6.] [9] Much D, Beyerlein A, Roßbauer M, et al. Beneficial effects of breastfeeding in women with gestational diabetes mellitus[ J]. Mol Metab, 214, 3(3): [] Kim C. Maternal outcomes and follow-up after gestational diabetes mellitus[ J]. Diabet Med, 214, 31(3): [11] Nielsen KK, Kapur A, Damm P, et al. From screening to postpartum follow-up - the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review[ J]. BMC Pregnancy Childbirth. 214, 14: 41. ( ) ( )

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