Prospective Study Of Diagnostic Criteria Of Gestational Diabetes Mellitus With Screening Test And Oral Glucose Tolerance Test

ObjectiveGestational glycometabolism abnormity includes gestational diabetes mellitus(GDM)and impair glucose tolerance(GIGT).GDM is defined as the onset or first recognition of glucose intolerance abnormity during pregnancy.The mechanism is indefinite,may be relative to insulin resistance.Although women with one elevated glucose tolerance test value will not be diagnosed with gestational diabetes mellitus, they are still at risk for adverse perinatal outcomes.This condition is associated with adverse outcomes of pregnancy such as hypertensive disorder complicating pregnancy, macrosomia,shoulder dystocia,fetal anomaly,fetal growth restriction.The study of GDM in China is not developed and has adopted the foreign diagnosis criteria for a long time.The National Diabetes Data Group(NDDG)and the American Diabetes Association(ADA)criteria are depend on the data from North America and Europe,it is deserving to discuss whether those criteria are suite for our country.The aim of the study is to compared the perinatal outcomes and find the eligible criteria for GDM and GIGT in our country through screening women with abnormal plasma glucose values after the screening test and a further OGTT.Subjective and Methods500 women of pregnant with 24 to 28 weeks gestation during prenatal examination or first visit exceed 28 weeks gestation in Shengjing Hospital affiliated to China Medical University.Using 50-g oral glucose loading test for those women.If the outcomes is positive,they need undergo further testing with oral glucose tolerance test.The method of detection is glucose oxidase method.ResultsThe difference significant in age,pre-body mass index,the value of screening, family history of GDM and multipara in three glycometabolism abnormity groups(P＜0.05).There were no significant differences in hypertensive diasorder complicating pregnancy,polyhydramnios,premature rupture of membrane,cesarean delivery in the patients who were diagnosed as GDM in three glycometabolism abnormity groups(P＞0.05).The difference is significant in polyhydramnios,premature rupture of membrane in earch group(P＜0.05).There were significant difference in hypertensive diasorder complicating pregnancy,premature rupture of membrane in gdestational diabetes mellitus patients who were diagnosed by National Diabetes Data Group and American Diabetes Association.There are no significant differences in preterm,macrosomia (birth weight≥4000g),low birth weight(birth weight＜2500g)in all glycometabolism abnormity groups(P＞0.05.There were significant differences in low birth weight between each Gestational glycometabolism group and control group(P＜0.05).Pre-body weight(prBM),pre-body weight index(preBMI)and age are influence in GDM(P＜0.05).They are risk factors.Statisticly AnalysisQuantitive variabes were expressed as mean±standard deviation,the groups were compared with T-test,one way ANOVA,chi-square test,logistic correlation analysis (using SPSS 12.0 software).P＜0.05 was considered as statistical significant.ConclusionsGDM and GIGT are result in perinatal and maternal outcomes such as hypertensive diasorder complicating pregnancy,cligoamnios,premature rupture of membrane,macrosomia and low birth weight.It is necessary to screening,diagnosis and treat for improve the adverse outcomes.Using the NDDG criteria may resule in missed diagnosis in our country.The ADA criteria and the criteria of the sixth version Obsteteics and Gynecology can use.The ADA criteia are profit of international exchange.