Comparative analysis of the metabolic profile and the course of pregnancy depending on the period of detection of gestational diabetes mellitus

• Yaroshenko Ekaterina S.

Abstract

Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women with which endocrinologists and obstetrician-gynecologists meet and, therefore, this is an important interdisciplinary problem. The prevalence of GDM in different countries of the world is 1.5-13% of the totalnumber of pregnancies. In mostpregnant women, gestational diabetes mellitus occurs with unexpressed hyperglycemia and the absence of obvious clinical symptoms, which complicates the diagnosis and Later detects. The purpose of the study was to conduct a comparative analysis of the metabolic profile and course of pregnancy depending on the period of detection of gestational diabetes mellitus. Material and methods. 103 individual cards ofpregnant women with gestational diabetes were processed. All women were divided into 2 groups, depending on the period of GDM detection: 1^st group (46 cards, 44.6% of the total number of cards) - until the 24^th week of gestation; 2^nd group (57 cards, 55.4% of the total number of cards) - after the 24thweek of gestation. In each group, the following metabolic profile parameters were determined: total cholesterol, glycemic profile, glycated hemoglobin, BMI, TSH level. The features of therapy, perinatal outcomes were analyzed. The study revealed that the difference in the frequency of insulin therapy is not statistically significant (in the group for the identifi-cationof GDM before the 24^th week- 1.1% more often). The mean values of total cholesterol and glycated hemoglobin practicallydo not differ in the GDM detection until the 24^th week and after (5.87 and 6.27 mmol/l; 5.3 and 5.25% respectively). The average level of glycemia is higher in the GDM detection group until the 24^th week (see annex). The caesarean section is 12.9% higher in the GDM detection group after the 24^th week. The frequency of birth of a large fetus (body weight more than 4000 g) is 2% higher in the GDM detection group until the 24^th week. When comparing BMI, obesity of grade 2 and 3 was more common in the 2^nd group(by 3 and 3.7% respectively). The level of TSH>2.5 mlU/L weas detected in the 1^st group at 16% more often.

Keywords:gestational diabetes mellitus, obesity, perinatal outcomes, metabolic profile

References

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