| The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. | |
| | |
MedLine Citation:
|
PMID: 15547538 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We sought to determine if the rate of preeclampsia is related to the severity of gestational diabetes mellitus (GDM), and if it can be decreased by optimizing glycemic control. STUDY DESIGN: A retrospective analysis of prospectively collective data of 1813 patients with GDM was performed to determine the rate of preeclampsia. Patients were stratified after treatment was begun by level of glycemic control (well controlled was defined as mean blood glucose <95 mg/dL). The extent of hyperglycemia was analyzed by the level of the abnormality in the oral GTT and by the degree of abnormality of daily glucose control after treatment has begun. Severity of GDM was categorized using fasting plasma glucose (FPG) on a 3-hour oral GTT by 10 mg/dL increments. RESULTS: Overall, preeclampsia was diagnosed in 9.6% (174/1813) of diabetic patients. The GDM subjects who developed preeclampsia were significantly younger, had a higher nulliparity rate, were more obese, and gained significantly more weight during pregnancy. However, no difference was found in glycemic profile characteristics between the 2 groups. A comparison between patients with FPG <105 and FPG >105 revealed that the rate of preeclampsia increased significantly, 7.8% vs 13.8%, (O.R 1.81, 95%CI 1.3-2.51). For GDM patients with only mild hyperglycemia (FPG <105 mg/dL), no significant difference was found in the rate of preeclampsia. Preeclampsia rate was further evaluated in relation to level of glycemic control; for the well-controlled patients (mean blood glucose [MBG] <95 mg/dL, n=994), similar rates of preeclampsia were found between each category of FPG severity. In contrast, in poorly controlled patients (MBG >95 mg/dL, n=819), a comparison between severity threshold of FPG <115 and FPG >115 revealed that the preeclampsia rate was 9.8% vs 18% (O.R 2.56, 95%C.I. 1.5-4.3). In a logistic regression model, only prepregnancy BMI (O.R 2.3, 95%CI 1.16-2.30) and severity of GDM (O.R 1.7, 95%CI 1.21-2.38) were independently and significantly associated with an increased risk of preeclampsia. CONCLUSION: The rate of preeclampsia is influenced by the severity of GDM and prepregnancy BMI. Optimizing glucose control during pregnancy may decrease the rate of preeclampsia, even in those with a greater severity of GDM. |
| | |
Authors:
|
Yariv Yogev; Elly M J Xenakis; Oded Langer |
Related Documents
:
|
9074678 - Intensive 50-week evaluation of glipizide administration in 50 cats with previously unt... 12855878 - Admission hyperglycemia as a prognostic indicator in trauma. 2053998 - A prospective evaluation of glucose reagent teststrips in the prehospital setting. 1902238 - Evaluation of a potential interaction between erythromycin and glyburide in diabetic vo... 16275148 - Novel actions of igfbp-3 on intracellular signaling pathways of insulin-secreting cells. 11806068 - Diabetic neuropathy masquerading as glossodynia. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: American journal of obstetrics and gynecology Volume: 191 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2004 Nov |
Date Detail:
|
Created Date: 2004-11-19 Completed Date: 2004-12-23 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
|
Languages: eng Pagination: 1655-60 Citation Subset: AIM; IM |
Affiliation:
|
Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, University Hospital of Columbia University, New York, New York, USA. ilanit@dlylaw.co.il |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Blood Glucose Diabetes, Gestational / complications, epidemiology*, pathology, prevention & control* Female Glucose Tolerance Test Humans Hypoglycemic Agents / therapeutic use Pre-Eclampsia / complications, epidemiology*, pathology, prevention & control* Pregnancy Prospective Studies Retrospective Studies Severity of Illness Index Texas / epidemiology |
| Chemical | |
Reg. No./Substance:
|
0/Blood Glucose; 0/Hypoglycemic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Interleukin-6, interleukin-8, and soluble tumor necrosis factor receptor-I in the cord blood as pred...
Next Document: Prophylactic antibiotics for non-laboring patients with intact membranes undergoing cesarean deliver...