Metabolický syndrom u GDM

Title in English Metabolic syndrome in GDM


Year of publication 2022
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Description Introduction Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Women with GDM not only have a higher rate of obstetric complications but also have a higher risk of developing diabetes, metabolic syndrome (MS) and cardiovascular disease after delivery or at any time later in life. However, MS may already precede pregnancy and GDM may then represent one of its components. The aims of this study were (i) to determine the prevalence of MS in patients at the time of diagnosis of GDM, (ii) to determine the prevalence of MS in a group of GDM patients in whom some form of glucose intolerance persisted after delivery, and (iii) to determine whether GDM patients with MS have a higher risk of obstetric complications (peripartum adverse outcomes). Methods The study included 455 women with GDM followed up between 2013 and 2019, 65% (n=295) had available data on delivery, 48% (n=219) of GDM patients underwent repeat oGTT testing within 1 year postpartum, of which 11.4% (n=25) were confirmed to have persistence or early conversion to permanent glucose intolerance (prediabetes or diabetes, assessed according to WHO). GDM was diagnosed according to the IADPSG criteria, IDF criteria for the definition of MS were modified due to pregnancy as follows: presence of at least 3 out of 5 criteria: GDM, prepregnancy BMI ?30 kg/m2, BP 130/85mmHg, TAG 1.7mmol/l, HDL 1.3mmol/l (parameters assessed in 2. In addition, the following peripartum parameters were assessed: need for induction, length of labour (prolonged labour), use of instrumentation during labour (section, forceps, vacuum extractor), Apgar score (pathology), baby weight (macrosomia). Patients were followed up at the Diabetology Centre of the University Hospital Brno, 65% of them gave birth at the University Hospital Brno. Results Fully developed MS was found in 22.6% (n=103) of GDM patients at 24-28 weeks of pregnancy. The incidence of MS was as high as 40% in those who remained with any form of impaired glucose tolerance after delivery. The course of delivery was statistically significantly influenced by the presence of MS in the two parameters studied - GDM patients with MS had significantly more pathological Apgar scores and more fetal macrosomia (p=0.01 and 0.0004, chi-square test). Conclusion The prevalence of MS in GDM patients diagnosed in pregnancy is a statistically significant risk factor (p=0.04 chi-square test) for the persistence of glucose intolerance after delivery, and negatively affects the course of labor. This work was supported by AZV grant NV18-01-00046 of the Ministry of Health of the Czech Republic.
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