Development of a New Risk Score for Stratification of Women with Gestational Diabetes Mellitus at High Risk of Persisting Postpartum Glucose Intolerance Using Routinely Assessed Parameters
Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic
Document type Journal Article
Grant support
16-28040A
Ministry of Health, Czech Republic
PubMed
34070991
PubMed Central
PMC8224770
DOI
10.3390/life11060464
PII: life11060464
Knihovny.cz E-resources
- Keywords
- gestational diabetes mellitus, peripartal outcomes, persisting glucose intolerance postpartum, risk score,
- Publication type
- Journal Article MeSH
The aims of the study were (i) to find predictive factors for early postpartum conversion of gestational diabetes mellitus (GDM) into persisting glucose intolerance (PGI), (ii) to evaluate potential differences in adverse perinatal outcomes in GDM women with and without early postpartum PGI and, finally, (iii) to establish a risk score to predict postpartum PGI. A cross-sectional study comprised 244 GDM patients with known age, parity, positive family history of diabetes, pre-gestational BMI, comorbidities, smoking history, results of mid-trimester oral glucose tolerance test, HbA1c, obstetric complications, neonatal outcomes and mode of delivery. A risk score was calculated using parameters with highest odds ratios in a statistic scoring model. Significant differences between women with and without PGI postpartum were ascertained for mid-trimester fasting plasma glucose (p < 0.001), HbA1c above 42 mmol/mol (p = 0.035), prevalence of obesity (p = 0.007), hypothyroidism, family history of diabetes and smoking. We also observed higher incidence of prolonged and complicated delivery in PGI group (p = 0.04 and 0.007, respectively). In conclusion, this study identified several parameters with predictive potential for early PGI and also adverse peripartal outcomes. We established a simple risk-stratification score for PGI prediction applicable for GDM affected women prior their leaving maternity ward. Yet, given a relatively small sample size as a main limitation of this study, the proposed score should be validated in the larger cohort.
Department of Nursing and Midwifery Masaryk University 625 00 Brno Czech Republic
Department of Obstetrics and Gynaecology University Hospital Brno 625 00 Brno Czech Republic
Department of Pathophysiology Faculty of Medicine Masaryk University 625 00 Brno Czech Republic
Department of Pediatrics University Children Hospital Černopolní 9 613 00 Brno Czech Republic
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