4.5 Article

Relationship between age of pregnant women with gestational diabetes mellitus and mode of delivery and neonatal Apgar score

Journal

WORLD JOURNAL OF DIABETES
Volume 13, Issue 9, Pages 776-785

Publisher

BAISHIDENG PUBLISHING GROUP INC
DOI: 10.4239/wjd.v13.i9.776

Keywords

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

Funding

  1. Hainan Province Clinical medical center
  2. High-level Talent Project of Hainan Provincial Natural Science Foundation [821RC685]

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The age of pregnant women with GDM is associated with the mode of delivery and neonatal Apgar score, with older age increasing the risk of adverse outcomes for mothers and infants.
BACKGROUNDGestational 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.AIMTo analyze the relationship between age of pregnant women with GDM and mode of delivery and neonatal Apgar score.METHODSA 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.RESULTSThe number of women with assisted pregnancy, & LE; 37 wk gestation, & GE; 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, & LE; 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).CONCLUSIONDelivery mode and Apgar score of pregnant women with GDM are related to age. Older age increases the adverse outcome of mothers and infants.

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