Retrospective Study About Pregnancy Outcomes Between New And Old Diagnostic Criteria For Gestational Diabetes Mellitus

ObjectiveTrue gestational diabetes mellitus (GDM) is an impairment in carbohydrate metabolism that first manifests during pregnancy. These patients may have borderline carbohydrate metabolism impairment state. However, during pregnancy, human placental lact-ogen and other hormones produced by the placenta act as anti-insulin agents leading to increased insulin resistance and generalized carbohydrate intolerance. This increased insulin resistance occurs in all pregnant women, but those in whom the balance between insulin function and resistance is tipped beyond an usual carbohydrate metabolism state will have elevated postprandial and occasionally fasting glucose. Because these placental hormones increase in volume with the size and function of the placenta, the carbohydrate metabolism abnormalities usually are not apparent until the late second trimester or early third trimester.MethodsCount the women of pregnant during prenatal examination in Fujian second peoples hospital affiliated to Fujian university of Traditional Chinese Medicine from May 1 2009 to Apr 30 2011, from May 1 2013 to Apr 30 2014. And calculate the gestational diabetes morbidity. Count the pregnant women who were in a single delivery, Analysis and synthesis the incidence of GDM and the pregnancy outcome between the diagnostic criteria for gestational diabetes mellitusThe Result1. The incidence of GDM of the Fujian second people’s hospital affiliated to Fujian university of Traditional Chinese Medicine about new diagnostic criteria was 8.4%, and 20.9% as to old diagnostic criteria.2. Between the two groups showing that associated and postoperative pregnancy complications of polyhydramnios and postpartum hemorrhage between the two groups showed significant differences(P<0.05).As to the method of pregnancy termination, caesarean section and difficult labour or forceps(P<0.05).Analysis of the pregnant outcome between the two groups showed that the morbidity of fetal macrosomia,fetal distress in uterus between the two groups showed significant differences (P<0.05)3. Based on the two diagnostic criteria in OGTT, the high effectiveness (about 50%) was at FPG(fasting plasma glucose)、1h and 2h after eating sugar to the groups used new diagnostic criteria.But as to the groups used old diagnostic criteria that the effectiveness at the time of 1h and 2h after eating sugar.4.GDM result in perinatal and maternal outcomes such as polyhydramnios,oligohy-dr amnion,hypertensive disorder complicating pregnancy,premature rupture of fetal membrane s,postpartum hemorrhage,fetal macrosomia. The diagnosis and treatment of GDM should be timely, using the old diagnostic criteria may result in missed diagnosis.Conclusions1.The rate of GDM increased significantly after using the new diagnostic criteria.2.Well-controlled glucose can completely improve maternal and fetal outconmes of GDM pregnant women,using the new diagnostic criteria can screening out more GDM women.