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. 2022 May 18;22(1):418.
doi: 10.1186/s12884-022-04712-0.

Clinical analysis of 2860 cases of diabetes in pregnancy: a single-center retrospective study

Jia Chen #  1   2 , Zhenyu Wang #  3 , Weizhen Wu  1 , Haixia Chen  2 , Caijuan Zhong  4 , Lixuan Liang  1 , Yingtao Li  5   6   7
Affiliations

Clinical analysis of 2860 cases of diabetes in pregnancy: a single-center retrospective study

Jia Chen et al. BMC Pregnancy Childbirth. .

Abstract

Background: To investigate the epidemiological, clinical characteristics and outcomes of diabetes in pregnancy (DIP).

Methods: This single-center, retrospective study included 16,974 pregnant women hospitalized during 2018-2019. Among them, 2860 DIP patients were grouped according to diabetes type, glycemic status, and insulin use. Multivariate logistic regression analysis was conducted.

Results: The incidence of DIP [17.10%; pregestational diabetes mellitus (PGDM), 2.00% (type I, 0.08%; type 2, 1.92%); gestational diabetes mellitus (GDM), 14.85% (GDM A1, 13.58%; GDM A2, 1.27%)] increased annually. Premature birth, congenital anomalies, large for gestational age (LGA), neonatal asphyxia, neonatal intensive care unit transfer, hypertension, and puerperal infection were more common in DIP than in healthy pregnancies. The most common comorbidities/complications were hypertension, thyroid dysfunction, cervical incompetence, intrahepatic cholestasis, premature membrane rupture, oligo/polyhydramnios, and fetal distress. GDM incidence at ages ≥35 and ≥ 45 years was 1.91 and 3.26 times that at age < 35 years, respectively. If only women with high-risk factors were screened, 34.8% GDM cases would be missed. The proportion of insulin use was 14.06% (PGDM, 55%; GDM, 8.53%). Mean gestational age at peak insulin dose in DIP was 32.87 ± 5.46 weeks. Peak insulin doses in PGDM and GDM were 3.67 and 2 times the initial doses, respectively. The risks of LGA, premature birth, cesarean section, and neonatal hypoglycemia in PGDM were 1.845, 1.533, 1.797, and 1.368 times of those in GDM, respectively. The risks of premature birth and neonatal hypoglycemia in women with poor glycemic control were 1.504 and 1.558 times of those in women with good control, respectively.

Conclusions: The incidence of adverse outcomes in DIP is high.

Keywords: Clinical characteristic; Diabetes; Insulin; Pregnancy; Pregnancy outcome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study. Comparisons of pregnancy outcomes in women with DIP, grouped according to the (A) type of diabetes (overall cohort) and insulin use (PGDM group) and (B) glycemic status. DIP, diabetes in pregnancy; PGDM, pregestational diabetes mellitus; GDM, gestational diabetes mellitus
Fig. 2
Fig. 2
Annual incidence of diabetes in pregnancy in the recent 5 years
Fig. 3
Fig. 3
Comparison of the incidence of adverse pregnancy outcomes in the study population and hospitalized DIP patients. DIP, diabetes in pregnancy; SGA, small for gestational age; LGA, large for gestational age; NICU, neonatal intensive care unit; HDPs, hypertensive disorders of pregnancy
Fig. 4
Fig. 4
Relationship between age and incidence of gestational diabetes mellitus
See this image and copyright information in PMC

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