| Abstract | Ustroj istraživanja: Retrospektivno istraživanje.
Mjesto istraživanja: Klinika za ženske bolesti i porode KBC-a Split.
Sudionici: Sve trudnice s gestacijskim dijabetesom melitusom (GDM), koje su rodile od siječnja 2013. do travnja 2014. godine, uključujući i one dijagnosticirane 2012. godine, koje su rodile 2013. godine. Iz istraživanja su isključene sve višeplodove trudnoće, mrtvorođena i malformirana novorođenčad, te one žene koje su bile hospitalizirane, ali nisu rodile u Klinici.
Glavne mjere ishoda: Ispitivali smo učestalost i čimbenike rađanja trudnica s GDM-om u Klinici i to: povezanost pariteta i životne dobi majki, načina rađanja, osnovna antropometrijska obilježja novorođenčadi, dob trudnoće, pojavnost mekonijske plodove vode, učestalost carskog reza i indukcije porođaja Prepidil gelom te prisutnost osobe u pratnji na porođaju.
Rezultati: U Klinici je analizirano 96 trudnoća i porođaja s GDM što čini 1,76% svih porođaja. Višerotke su češće oboljevale od GDM-a (x2=4,71; P=0,03). Trudnice s GDM-om su statistički češće (x2= 12,01; P=0,0005) rađale mušku djecu. Porođajna masa, duljina i ponderalni indeks nisu bili statistički značajno veći u odnosu na kontrolnu skupinu. Makrosomna novorođenčad (>4000g) su se rađala češće uz GDM, ali bez statističke značajnosti (x2=1,79; P=0,25). U periodu od 37. do 39. tjedna trudnoće rodilo je 72,9% trudnica s GDM-om, značajno više u odnosu na kontrolnu skupinu (x2=8,07; P=0,0045). Carskim rezom je rodilo 37,5% rodilja s GDM-om, za 50% više nego u kontroli (x2=3,78; P=0,04). Indukcija porođaja Prepidil gelom je kod GDM-a korištena pet puta češće (10,4% : 2,2%). Partner na porođaju je bio prisutan značajno rjeđe u trudnica s GDM-om ( 4,2% : 15,6%) (x2=7,1;P=0,008). Mekonijska plodova voda je evidentirana rjeđe uz GDM (5,2% : 16,6%) (x2=6,47; P=0,01).
Zaključak: GDM predstavlja značajan čimbenik perinatalnog ishoda. Saznanje kako mogući problemi ne prestaju trenutkom porođaja već plod prate kroz cijeli život, a trudnici signaliziraju moguć nastup dijabetesa tip 2, postavljaju ga na još značajnije mjesto u promišljanju o trudnoći, antenatalnoj zaštiti i zdravlju uopće. |
| Abstract (english) | Study design: Retrospective study.
Study location: Department of Obstetrics and Gynecology, University Hospital Split.
Participants: Study included parturient woman with gestational diabetes mellitus (GDM) who delivered newborns between January 2013 and April 2014, including ones diagnosed in 2012 who delivered in 2013. Multiple pregnancies, stillbirths and newborns with malformations were excluded, and women who were hospitalised at the Clinic but didn't delivered at the Clinic.
Main outcome measures: We examined the frequency and factors of birth of the newborns who's mothers had GDM at the Clinic: maternal parity, mother's age, mode of birth of newborns who's mothers had GDM , main anthropometric characteristics, gestational age, meconium amniotic fluid, frequency of cesarean delivery, labor induced by Prepidil gel and accompaniment during labor were examined.
Results: At the Clinic 96 pregnancies an labors with GDM were analised, which makes 1,76% all labours. Multiparous women had GDM more frequently (x2=4,71; P=0,03). Women with GDM were delivering male newborns more frequently and with statistically significant difference (x2= 12,01; P=0,0005). Birth weight, lenght and ponderal index were not statisticaly different compared to control group. Macrosomic newborns (>4000g) were born more frequently by mothers with GDM, but there wasn't statisticaly significant difference (x2=1,79; P=0,25). In a period from 37th to 39th gestational week 72,9% women with GDM delivered newborns, which was statisticaly significant difference compared to control group (x2=8,07; P=0,0045). Cesarean delivery was used in 37,5% women with GDM which was statisticaly significant difference compared to control group (x2=3,78; P=0,04). Prepidil gel was used statisticaly more in labors of women with GDM (10,4%: 2,2%). Accompaniment during labor was present significantly less with women with GDM ( 4,2% : 15,6%) (x2=7,1;P=0,008). Meconium amniotic fluid was recorded less frequent at women with GDM (x2=6,47; P=0,01).
Conclusion: GDM presents an important risk of perinatal outcome. Knowledge that possible problems don't end with labor, that they accompany child through whole life, and that they signalize possible appearance of diabetes type 2 at pregnant women, they set it at more important place when we talk about pregnancy, antenatal protection and health at all. |
