Course of pregnancy and delivery in women with the disorders of carbohydrate metabolism

Abstract

E.V. Shaposhnikova1, M.I. Bazina1, M.M. Mentsik2, E.V. Shageeva2, T.A. Shageev1 1Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk,  Russian Federation 2I.S. Berzon Krasnoyarsk Interregional City Hospital No. 20, Krasnoyarsk, Russian Federation Background: disorders of carbohydrate metabolism are one of the common complications of pregnancy associated with the increasing rate of adverse maternal and neonatal outcomes. The introduction of the guidelines-based approaches to the diagnosis of these conditions and the management of pregnancy and childbirth aims to reduce the risks of these complications. Aim: to assess the prevalence of the disorders of carbohydrate metabolism and to analyze the course of pregnancy and childbirth, and perinatal outcomes in 2017–2019. Patients and Methods: case records of 1,188 women with the disorders of carbohydrate metabolism who were admitted to a maternity hospital and gave birth were analyzed. Results: over the last 3 years, gestational diabetes ranks 1st among the disorders of carbohydrate metabolism. Its percentage increased by 1.7 times, i.e., from 11.4% to 19.8% (OR=0.6, 95% CI 0.51–0.67; p<0.001). The most common extragenital comorbidity was obesity (46.8%). During the analyzed period, a 1.8-fold reduction (from 11.6% to 6.3%) in the rate of moderate preeclampsia (OR=1.8, 95% CI 1.19–2.88, p=0.01) and a 2-fold reduction (from 21,9% to 10,8%) in the rate of diabetic fetopathy (OR=0.5, 95% CI 0.36–0.68, p<0.001) were observed. Careful examinations and follow-up allowed for the reduction in the rate of С-section by 11.5%, i.e., from 54.1% in 2017 to 42.6% in 2019 (OR=1.3, 95% CI 1.11–1.46, p=0.002). Meanwhile, the major indication to C-section in these women is diabetic fetopathy. Conclusions: early diagnosis of the disorders of carbohydrate metabolism and adequate management provide the reduction in the rate of complications and the conditions for vaginal delivery in full-term pregnancy. Keywords: pregnancy, gestational diabetes, disorders of carbohydrate metabolism, glucose tolerance test, delivery, perinatal outcomes. For citation: Shaposhnikova E.V., Bazina M.I., Mentsik M.M. et al. Course of pregnancy and delivery in women with the disorders of carbohydrate metabolism. Russian Journal of Woman and Child Health. 2020;3(3):163–168. DOI: 10.32364/2618-8430-2020-3-3-163-168.