Preeklampsie sdružená s GDM
| Title in English | Preeclampsia associated with GDM |
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| Authors | |
| Year of publication | 2023 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Introduction Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Women with GDM not only have a higher rate of obstetric complications but also a higher incidence of other cardio-metabolic comorbidities associated with the development of glucose intolerance. The possible pathophysiological association of GDM with pre-eclampsia (PE) is still unclear. PE is characterized by new-onset hypertension after 20 weeks of pregnancy (BP?140/90 mmHg) and proteinuria (>300 mg/24 h), or edema. The reported incidence of pre-eclampsia in the country is about 4-6%. The objectives of the study were (i) to determine the prevalence of PE in healthy pregnant and GDM patients over a defined time period, (ii) to determine the prevalence of PE in a group of GDM patients who had some form of glucose intolerance persisting after delivery, and (iii) to determine whether GDM patients with PE and GDM have a higher risk of obstetric complications (peripartum adverse outcomes). Methods The study included 861 women followed up from 2013-2019 (409 controls and 452 women with GDM), 73.8% (n=635) had available data on delivery, 48.5% (n=219) of GDM patients underwent repeat oGTT testing within 1 year postpartum, of which 11.4% (n=25) were confirmed to have persistence or GDM was diagnosed according to IADPSG criteria, PE according to ISSHP criteria. In addition, the following peripartum parameters were evaluated: the need for induction, length of labor (prolonged labor), use of instrumentation during labor (section, forceps, vacuum extractor), Apgar score (pathology), and baby weight (macrosomia). Patients with GDM were followed up at the Diabetology Centre of the University Hospital Brno. Results PE was diagnosed in 4.6% (n=19) of controls and 10.4% (n=47) of GDM patients. In those who remained with any form of impaired glucose tolerance after delivery, the incidence of PE was 20%. The presence of PE also affects the course of labor-patients with PE undergo (planned) cesarean delivery more often and labor is more often induced. Conclusion The incidence of PE in GDM patients is statistically significantly higher than in the control group (P=0.022 Chi-squared test), it negatively affects the course of labour independently of the presence of GDM, therefore, cesarean delivery is more frequently performed. Patients with any form of persistent glucose intolerance after delivery have a higher incidence of PE and risk of other peripartum complications. |
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