Influences of strengthening the management of gestational diabetes mellitus on the pregnant women with abnormal glucose metabolism

Objective To compare the pregnancy complications and outcomes between pregnant women with abnormal glucose metabolism and those with normal glucose metabolism before and after the standard management were carried out.Methods The pregnant women with abnormal glucose metabolism were selected for case group and those with normal glucose metabolism during the same period were selected for control group respectively.The first stage is from 1996 to 2001 and the second stage is from 2002 to 2007 because the standard management was carried out in 2002 in our hospital.There were 122 subjects in case group and 5967 subjects in control group in the first stage.The second stage included 596 subjects in case group and 5272 subjects in control group.The glucose screening test was never carried out in the first stage.The oral glucose tolerance test(OGTT) was taken only when fasting glucose level was more than 5.6 mmol/L.In the second stage,50 gram glucose screening test was taken in the antenatal care women in 24th-28th gestational week.When the result was more than 7.8 mmol/L,the OGTT was carried out and the patient would be specially cared.Results There were 122 pregnancy women with abnormal glucose metabolism.The incidence rate was 2.00%,including 0.84% in pregnancy with DM,0.84% in GDM and 0.32% in GIGT.There were 596 pregnancy women with abnormal glucose metabolism.The incidence rate was 10.16%,including 0.78% in pregnancy with DM,4.29% in GDM and 5.08% in GIGT.Before the standard management were carried out,the incidence of premature delivery,macrosomia,polyhydramnios and fetal deformity in case group were 12.30%,13.93%,4.10% and 3.28% respectively,which were significantly higher than those in control group as 5.33%,3.62%,0.96% and 0.72% respectively.There were not any statistically differences of hypertensive disorders in pregnancy,fetal growth restriction,fetal death and neonatal hyperbilirubinemia between the two groups.After the standard management were carried out,there was no difference in the incidence of pregnancy complications and pregnancy outcomes between two groups except that the incidence of premature delivery in case group(11.24%) was higher than that in control group(8.61%).Conclusions Strengthening the management of pregnant women with abnormal glucose metabolism can decrease the pregnancy complications and improve the pregnancy outcomes.