engleski

The influence of glycemia control on incidence of preeclampsia/ eclampsia in GDM pregnancies

Inadequate regulation of glycemia in women with gestational diabetes mellitus is associated with an increased risk of pre-eclampsia and other complications through pregnancy. The GDM subjects who developed pre-eclampsia were significantly younger, had a higher nulliparity rate, were more obese, and gained significantly more weight during pregnancy. Aim of the study. A retrospective analysis of prospectively collective data of 1354 in GDM pregnant women through period between 2001 to 2010 was performed to determine the rate of pre-eclampsia. The aim of the study is to analyze the incidence of preeclampsia and other risk factors in GDM pregnant women. Study design and methods. During the period 2001-2010, we followed up 1354 consecutive unselected pregnancies in women with gestational diabetes mellitus. Glycemic control was assessed by HbA1c at the time of diagnose. Pre-eclampsia was defined as RR >140/90 mmHg combined with albuminuria of >0.3 g/L. The occurence of pre-eclampsia was also associated in a control group comprising 2387 unselected pregnant women. Results. Pre-eclampsia developed in 35 women (2, 6%) with gestational diabetes and in 27 women (1, 1%) of the controls ; χ2=11, 119 (CI 95% 0, 57 – 2, 56), p<0, 001 ; RR = 2, 29 (CI 95% 1, 39 – 3, 76) p<0, 001. After adjustment by logistic regression, both the FBG and PBG and their changes during pregnancy remained significant predictors for pre-eclampsia. The odds for pre-eclampsia increased by a factor of (1.2) for each 1 mmol/L increment in initial FBG level and PBG level, and decreased by factor of (0.8) for each 1 mmol/L decreased of FBG or PBG level achived during pregnancy. Conclusion. The results suggest that in GDM pregnant women had an independent and significant association between GDM and pre-eclampsia. The occurrence of pre-eclampsia in these women is closely related to the plasma glucose level at GDM diagnosis and how well the maternal glucose level is controlled. A model based on clinical data yielded predicted the development of pre-eclampsia in women with GDM.

glycemia; preeclampsia; eclampsia; gestational diabetes mellitus

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