Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2022; 13(9): 776-785
Published online Sep 15, 2022. doi: 10.4239/wjd.v13.i9.776
Relationship between age of pregnant women with gestational diabetes mellitus and mode of delivery and neonatal Apgar score
Lan Gao, Cun-Ren Chen, Fei Wang, Qun Ji, Kai-Ning Chen, Yang Yang, Hai-Wei Liu
Lan Gao, Cun-Ren Chen, Fei Wang, Qun Ji, Kai-Ning Chen, Hai-Wei Liu, Department of Endocrinology, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Yang Yang, Department of Obstetrics and Gynecology, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Author contributions: Gao L and Chen CR contributed equally to this work; Gao L and Chen CR drafted the manuscript; Yang Y provision patients; Gao L, Wang F, Ji Q collected the data; Chen CR and Liu HW analyzed and interpreted the data; Liu HW contributed to conception and design; Chen KN contributed to administrative support.
Supported by Hainan Province Clinical medical center and The High-level Talent Project of Hainan Provincial Natural Science Foundation, No.821RC685.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Hainan General Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Wei Liu, MD, Professor, Department of Endocrinology, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. lhw15208981757@hainmc.edu.cn
Received: May 26, 2022
Peer-review started: May 26, 2022
First decision: June 20, 2022
Revised: July 1, 2022
Accepted: July 31, 2022
Article in press: July 31, 2022
Published online: September 15, 2022
ARTICLE HIGHLIGHTS
Research background

Gestational diabetes mellitus (GDM) is one of the serious pregnancy complications, which severely threatens the health of pregnant women and newborns. In recent years, with the increased childbearing age and proportion of overweight people, the incidence of GDM has an upward trend. The detrimental effect of GDM on the prognosis has been recognized, which can increase the incidence of dystocia, cesarean section and macrosomia, and 17%-63% of pregnant women and infants will develop type 2 diabetes in the long term.

Research motivation

We analyzed the risk factors affecting the adverse outcomes of mothers and infants, we also put forward targeted prevention and control measures to provide reference for formulating GDM early prevention and intervention policies.

Research objectives

To explore the relationship between the age of GDM pregnant women and the delivery mode and neonatal Apgar score, so as to provide a theoretical basis for reducing the incidence of adverse pregnancy outcomes.

Research methods

We used the latest diagnostic criteria of GDM to investigate pregnant women who met the inclusion criteria, and collected their general conditions before and during pregnancy and related clinical data. The women were divided into right age group and older group according to whether they were older than 35 years old. Logistic regression analysis was used to analyze the related risk factors affecting the delivery outcome of GDM pregnant women.

Research results

The older group had a higher cesarean section rate, higher incidence of polyhydramnios and postpartum hemorrhage, and lower incidence of fetal distress than the right age group. The right age group had higher Apgar scores at 1 and 5 min after birth than the older group. Moreover, age, education level and premature rupture of membranes were risk factors for adverse pregnant outcomes in older GDM women. Our results showed that gestational age greater than 35 years old will increase the incidence of gestational diabetes and adverse pregnancy outcomes, but it needs to be confirmed by large samples and studies involving patients in multiple research centers.

Research conclusions

The age of pregnant women with GDM affects the delivery mode and neonatal Apgar score, and advanced age increases the adverse pregnancy outcomes. Therefore, it is suggested that pregnant women should have pre-pregnancy eugenics health examination and pregnancy health care.

Research perspectives

In the future research, we want to explore the effective means of screening GDM in pregnancy physical examination, as well as the means of early intervention and treatment for pregnant women with high-risk factors of GDM.