ROLE OF EARLY SCREENING FOR GESTATIONAL DIABETES MELLITUS IN OPTIMIZING PERINATAL OUTCOMES


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To assess the role of early screening for gestational diabetes mellitus (GDM) in optimizing perinatal outcomes. Subject and methods. A prospective comparatively study was conducted in 2 groups of pregnant women with GDM. The time for detection of GDM was 14.5±7.5 and 27.2±7.6 weeks in Groups 1 (n=44) and 2 (n=97), respectively. In both groups, the diagnosis of GDM was verified using the WHO criteria (1999). There were no differences between the groups in treatment policies for GDM. Results. The early diagnosis of GDM was accompanied 1.8-, 3.1-, and 2-fold less frequently by fetoplacental insufficiency, macrosomia, and cesarean section, respectively. There were no cases of preterm delivery and neonatal hypoglycemia in Group 1 whereas Group 2 showed these conditions in 20.6 and 11.3% of cases, respectively. Analyzing our results according to the new criteria for GDM (Russian National Consensus, 2012) revealed a fasting venous plasma glucose level of ≥5.1 mmol/l in 88.6% of the patients who were found to have GDM according to the WHO criteria and oral glucose tolerance test (OGTT). Conclusion. The early detection of GDM and hence the timely correction of carbohydrate metabolic disturbances permit the optimization of perinatal outcomes. The GDM diagnostic criteria recommended by the Russian National Consensus allow an early screening in all pregnant women without being divided into risk groups and a first-trimester diagnosis of the disease without carrying out an OGTT in most patients.

Full Text

Restricted Access

About the authors

E. G DERYABINA

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of the Russian Federation

Email: helen_mic@mail.ru
Yekaterinburg

N. V BASHMAKOVA

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of the Russian Federation

Email: zamdirnir@k66.ru
Yekaterinburg

D. M LARKIN

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of the Russian Federation

Email: larkin-78@mail.ru
Yekaterinburg

References

  1. Сухих Г.Т., Краснопольский В.И., Рунихина Н.К., Ткачева О.Н., Ходжаева З.С., Петрухин В.А. и др. Переход на новый уровень ведения гипертензивных и метаболических осложнений при беременности: современные критерии диагностики гестационного сахарного диабета. Акушерство и гинекология. 2013; 3: 4—9.
  2. Дедов И.И., Краснопольский В.И., Сухих Г.Т. Российский национальный консенсус «Гестационный сахарный диабет: диагностика, лечение, послеродовое наблюдение». Сахарный диабет. 2012; 4: 4—10.
  3. Григорян О.Р., Шереметьева Е.В., Андреева Е.Н., Дедов И.И. Современные аспекты гестационного сахарного диабета: патофизиология, скрининг, диагностика и лечение. Проблемы репродукции. 2011; 1: 98—105.
  4. Landon M.B., Spong C.Y., Thom E., Carpenter M.W., Ramin S.M., Casey B. et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N. Engl. J. Med. 2009; 361(14): 1339—48.
  5. Metzger B.E., Lowe L.P., Dyer A.R., Trimble E.R., Sheridan B., Hod M. et al. Hyperglycemia and adverse pregnancy outcome (HAPO) study associations with neonatal anthropometrics. Diabetes. 2009; 58(2): 453—9.
  6. Black M.H., Sacks D.A., Xiang A.H., Lawrence J.M. Clinical outcomes of pregnancies complicated by mild gestational diabetes mellitus differ by combinations of abnormal oral glucose tolerance test values. Diabetes Care. 2010; 33: 2524—30.
  7. Visser G.H.A., Yogev Y. Obesity and metabolic disorders during pregnancy and pregnancy outcome. In: Mahmood T.A., Sabaratnam Arulkumaran S., eds. Obesity: a ticking time bomb for reproductive health. London: Elsevier; 2012: 269—88.
  8. Sacks D.A., Hadden D.R., Maresh M., Deerochanawong C., Dyer A.R., Metzger B.E. et al. Frequency of gestational dia betes mellitus at collaborating centers based on IADPSG consensus panel—recommended criteria: the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Diabetes Care. 2012; 35(3): 526—8.
  9. Moses R.G., Morris G.J., Petocz P., San Gil F., Garg D. The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med. J. Aust. 2011; 194(7): 338—40.
  10. Петрухин В.А., Бурумкулова Ф.Ф., Титова Т.В., Головченко М.А., Котов Ю.Б. Распространенность гестационного сахарного диабета в Московской области: результаты скрининга. Российский вестник акушера-гинеколога. 2012; 4: 81—4.
  11. Дерябина Е.Г., Башмакова Н.В., Ларькин Д.М. Проблемы скрининга гестационного сахарного диабета в современном мегаполисе. Российский вестник акушера-гинеколога. 2012; 6: 46—8.
  12. Капустина М.В., Петрухин В.А., Бурумкулова Ф.Ф., Долгиева Л.У., Лукашенко С.Ю. Экстракорпоральное оплодотворение и гестационный сахарный диабет: новая проблема. Российский вестник акушера-гинеколога. 2011; 1: 73—6.
  13. Рагозин А.К., Колегаева О.И., Демидова И.Ю., Арбатская Н.Ю. Новые критерии диагностики гестационного сахарного диабета. Журнал акушерства и женских болезней. 2011; 3: 122—9.
  14. Дедов И.И., Шестакова М.В., ред. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 5-е изд. доп. М.; 2011. 115с.
  15. Дедов И.И., Шестакова М.В., ред. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 4-е изд. доп. М.; 2009. 104с.
  16. Kitzmiller J.L., Block J.M., Brown F.M., Catalano P.M., Conway D.L., Coustan D.R. et al. Managing preexisting diabetes for pregnancy: summary of evidence and consensus recommendations for care. Diabetes Care. 2008; 31(5): 1060—79.
  17. Дерябина Е.Г., Башмакова Н.В., Шабунина-Басок Н.Р., Изместьева К.А. Сахарный диабет и беременность: возможно ли предотвратить перинатальные осложнения? В кн.: Материалы XIII Всероссийского научного форума «Мать и дитя». М.; 2012: 42—3.
  18. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33(3): 676—82.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2013 Bionika Media