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
Processing time: 106 Days and 5.9 Hours
Abstract
BACKGROUND

Gestational diabetes mellitus (GDM) refers to abnormal glucose tolerance during pregnancy, and it is often accompanied by obvious changes in glucose and lipid metabolism, and associated with adverse pregnancy outcomes. The incidence of fetal distress, polyhydramnios, puerperal infection, premature delivery, and macrosomia in pregnant women with GDM are higher than in those without GDM.

AIM

To analyze the relationship between age of pregnant women with GDM and mode of delivery and neonatal Apgar score.

METHODS

A total of 583 pregnant women with GDM who delivered in the Department of Obstetrics at our hospital between March 2019 and March 2022 were selected. Among them, 377 aged < 35 years were selected as the right age group and 206 aged > 35 years were selected as the older group. The clinical data of the two groups were collected, and the relationship between age of the pregnant women with GDM and mode of delivery, maternal and neonatal outcomes, and neonatal Apgar score were compared. In the older group, 159 women were classed as the adverse outcome group and 47 as the good outcome group according to whether they had adverse maternal and infant outcomes. The related factors of adverse maternal and infant outcomes were analyzed through logistic regression.

RESULTS

The number of women with assisted pregnancy, ≤ 37 wk gestation, ≥ 2 pregnancies, one or more deliveries, and no pre-pregnancy blood glucose screening in the older group were all higher than those in the right age group (P < 0.05). The natural delivery rate in the right age group was 40.85%, which was higher than 22.33% in the older group (P < 0.05). The cesarean section rate in the older group was 77.67%, which was higher than 59.15% in the right age group (P < 0.05). The older group had a higher incidence of polyhydramnios and postpartum hemorrhage, and lower incidence of fetal distress than the right age group had (P < 0.05). There was no significant difference in neonatal weight between the two groups (P > 0.05). The right age group had higher Apgar scores at 1 and 5 min than the older group had (P < 0.05). Significant differences existed between the poor and good outcome groups in age, education level, pregnancy mode, ≤ 37 wk gestation, number of pregnancies, and premature rupture of membranes (P < 0.05). Logistic regression showed that age, education level and premature rupture of membranes were all risk factors affecting the adverse outcomes of mothers and infants (P < 0.05).

CONCLUSION

Delivery mode and Apgar score of pregnant women with GDM are related to age. Older age increases the adverse outcome of mothers and infants.

Keywords: Gestational diabetes mellitus; Age; Mode of delivery; Neonatal Apgar score

Core Tip: This study analyzed the relationship between the age of pregnant women with gestational diabetes mellitus (GDM) and mode of delivery and neonatal Apgar score. Pregnant women with GDM were divided into right age and older groups. Compared with the older group, the natural delivery rate in the right age group was higher, but the cesarean section rate was lower. Moreover, age, education level and premature rupture of membranes were associated with the adverse outcomes of mothers and infants. Age was related to the delivery mode and Apgar score of pregnant women with GDM.