Endocrine Abstracts

Background and aims: Published data on the prevalence of GDM and its complications in real clinical practice in Russia are insufficient. To assess the prevalence of GDM among pregnant women in one of the districts of Moscow, the structure of risk factors, the course and outcomes of pregnancy in women with GDM.

Materials and Methods: A retrospective analysis of data from the primary documentation of 510 pregnant women who were diagnosed with GDM during 2019.

Results: GDM was diagnosed in 510 pregnant women out of 5000 observed (10.2%). The mean age of women was 31.9±4.8 (95% CI 31.5-32.3). The diagnosis was made in the 1st trimester of pregnancy - 224 pregnant women (43.9%), in the 2nd trimester - 31.8% (162), in 18.6% (95) in the 3rd trimester. Mean values of venous plasma glucose - 5.43 [5.25; 5.7] mmol/l, HbA1c - 5.19±0.4% (95% CI 5.15-5.24). Treatment with diet therapy - 84.3%, the rest - insulin therapy (in all cases, aspart and detemir were used). The structure of risk factors: burdened hereditary history - 206 (40.4%), GDM in previous pregnancies - 54 (10.6%), macrosomia in history - in 6.3% of cases; antenatal fetal death in history - 3 (0.59%). Obesity was found in 120 (23.5%) women: BMI 30-34.9 kg/m² was recorded - 14.3%, BMI 35-39.9 kg/m² - in 5.1%, BMI 40 kg/m² or more - 4.1%. Pregnancy complications were observed in 123 women (24.1%): in 64 (12.5%) cases - fetoplacental insufficiency; preeclampsia - 54 (10.6%); 1 of the pregnant women - eclampsia; the threat of abortion and the threat of premature birth - 1.56% and 1.96%. In 12 pregnant women (2.35%) - polyhydramnios, in 18 cases (3.52%) - oligohydramnios. Adverse pregnancy outcomes were registered in 153 women with GDM out of 213 analyzed (71.8%): caesarean section in 22.5% of cases; premature rupture of amniotic fluid - in 58 (27.2%); macrosomia - 16.43%; ruptures of the pelvic organs - 41.31%; clavicle fracture - 2 cases; cephalohematoma - 3 cases; distress syndrome - in 6 newborns (2.82%); congenital malformations - in 2 newborns. CNS depression syndrome (7.98%), fetal cerebral ischemia - in 8.92%.

Conclusions: Totally unfavorable pregnancy outcomes were significantly more common in the group with earlier manifestation of GDM (60.7%) compared with the 2nd group (37.7%) (р<0.001). A detailed comparison of pregnancy complications in these groups showed no statistically significant difference.