The total number of deliveries after 22 weeks of gestation at our hospital during the study period was 10,548. Of these, 7076 patients underwent the 50-g GCT and 5852 had normal results (< 140 mg/dL). Among them, 268 patients underwent the 75-g OGTT after 29 weeks of gestation. Of them, 238 patients were included in the analysis, excluding 3 women with multiple gestations and 27 who had a previous caesarean delivery. Among these subjects, 189 women comprised the NGT group and 49 women comprised the GDM group (Fig. 1).
Table 1 summarises the maternal backgrounds of the two groups. The median ages at delivery were 32 years (IQR, 28–35 years) and 31 years (IQR, 28–35 years) in the NGT group and GDM group, respectively, with no difference between groups (p = 0.46). There were no differences in height, pre-pregnancy weight, and BMI. Weight at delivery was lighter in the GDM group than in the NGT group (60.6 kg [IQR, 56.5–69.9] and 64.6 kg [IQR, 58.6–71.1], respectively); however, the difference was not statistically significant (p = 0.14). Gestational weight gain was significantly lower in the GDM group than in the NGT group (9.0 kg and 11.0 kg, respectively; p = 0.02). There was a higher proportion of male newborns in the GDM group than in the NGT group (71.4% and 51.8%, respectively; p = 0.01). Three women (6.1%) in the GDM group were treated with insulin.
Table 1
Characteristics of each group
|
NGT
n = 189
|
GDM
n = 49
|
p value
|
Maternal age (yo)
|
32 (28–35)
|
31 (28–35)
|
0.46
|
Maternal height (cm)
|
159 (155–162)
|
157 (153–163)
|
0.16
|
Pre-pregnancy weight (kg)
|
52.8 (48.0–58.0)
|
50.6 (47.0-57.5)
|
0.47
|
Pre-pregnancy BMI (kg/m2)
|
20.7 (19.2–22.5)
|
20.5 (18.8–22.8)
|
0.90
|
Weight at delivery (kg)
|
64.6 (58.6–71.1)
|
60.6 (56.5–69.9)
|
0.14
|
BMI at delivery (kg/m2)
|
25.4 (23.5–27.6)
|
24.9 (22.4–27.8)
|
0.48
|
Gestational weight gain (kg)
|
11.0 (8.9–13.8)
|
9.0 (7.2–12.8)
|
0.02
|
Multipara
|
72 (38.1)
|
20 (40.8)
|
0.73
|
Insulin treatment
|
0 (0)
|
3 (6.1)
|
-
|
Data are n (%) or median (IQR: Inter Quartile Range) |
Table 2 summarises the gestational and neonatal outcomes of both groups. The rates of diabetes-related complications were 13.8% and 18.4% in the NGT group and GDM group, respectively; this difference was not statistically significant (aOR, 1.31; 95% CI, 0.56–3.06; p = 0.53). There were no statistically significant differences in the rates of macrosomia, shoulder dystocia, hypoglycaemia, or hyperbilirubinaemia between the two groups. None of the infants developed RDS. The overall caesarean delivery rate was significantly higher in the GDM group than in the NGT group (28.6% and 15.9%, respectively; aOR, 2.41; 95% CI, 1.07–5.43; p = 0.04). The rate of elective caesarean deliveries was also higher in the GDM group than in the NGT group (16.3% and 5.3%, respectively; aOR, 3.60; 95% CI, 1.27–10.19; p = 0.01). However, the rates of emergency caesarean deliveries were not significantly different between groups (10.6% for the GDM group and 12.2% for the NGT group; aOR, 1.25; 95% CI, 0.43–3.64; p = 0.74). Birth weights were 3222 g (IQR, 2911–3541 g) in the NGT group and 3189 g (IQR, 2949–3496 g) in the GDM group; this difference was not significant (aRC, -13.3; 95% CI, -83–56; p = 0.71). The rates of LGA status were 31.6% in the NGT group and 24.0% in the GDM group, which were higher than the general rates; however, there was no significant difference between groups (p = 0.20). The rates of SGA status were lower than the general rates of 5.2% in the NGT group and 6.0% in the GDM group; however, the difference was not significant. Additionally, there were no significant differences in low APS, low UApH, and NICU admission rates between groups.
Table 2
Pregnancy delivery and neonatal outcomes
|
NGT
|
GDM
|
|
|
|
|
n = 189
|
n = 49
|
*aOR
|
95% CI
|
p value
|
Diabetes-related composite complication**
|
26 (13.8)
|
9 (18.4)
|
1.31
|
0.56–3.06
|
0.53
|
Macrosomia
|
10 (5.3)
|
3 (6.1)
|
0.98
|
0.25–3.86
|
0.97
|
Shoulder dystocia
|
6 (3.2)
|
3 (6.1)
|
1.6
|
0.37–6.85
|
0.53
|
Hypoglycemia
|
2 (1.1)
|
2 (1.1)
|
3.71
|
0.49–27.84
|
0.2
|
Hyperbilirubinemia
|
11 (5.8)
|
2 (4.1)
|
0.74
|
0.15–3.61
|
0.71
|
RDS
|
0
|
0
|
-
|
-
|
-
|
Preeclampsia
|
11 (5.8)
|
0
|
-
|
-
|
-
|
Total Caesarian delivery
|
30 (15.9)
|
14 (28.6)
|
2.41
|
1.07–5.43
|
0.03
|
Selective Caesarian delivery
|
10 (5.3)
|
8 (16.3)
|
3.6
|
1.27–10.19
|
0.02
|
Emergency Caesarian delivery
|
20 (10.6)
|
6 (12.2)
|
1.25
|
0.43–3.64
|
0.68
|
Instrumental delivery
|
17 (9.0)
|
3 (6.1)
|
0.69
|
0.18–2.59
|
0.58
|
Large for gestational age
|
59 (31.2)
|
11 (22.5)
|
0.54
|
0.25–1.17
|
0.12
|
Small for gestational age
|
11 (5.8)
|
3 (6.1)
|
1.01
|
0.26–3.90
|
0.99
|
Apgar score at 5 min < 7
|
0
|
0
|
-
|
-
|
-
|
UApH < 7.1
|
3 (1.6)
|
2 (4.1)
|
2.55
|
0.39–16.50
|
0.33
|
NICU admission
|
9 (4.8)
|
4 (8.2)
|
1.68
|
0.48–5.86
|
0.41
|
Neonatal admission
|
17 (9.0)
|
5 (10.2)
|
1.07
|
0.37–3.15
|
0.9
|
|
|
|
*aRC
|
|
|
Neonatal weight (g)
|
3222
(2911–3541)
|
3182
(2949–3496)
|
-24
|
-97-49
|
0.52
|
Gestational age at delivery (weeks)
|
39.6
(38.7–40.6)
|
39.6
(38.7–40.4)
|
0.04
|
-0.16-0.24
|
0.69
|
Data are median (IQR) or n (%). |
*aOR/ aRC: adjusted Odds ratio/ regression coefficient, adjusted for maternal age, non-pregnant BMI, childbirth experience, and sex of the infant. |
** Diabetes-related composite complication defined as any one of the following: macrosomia, shoulder dystocia, neonatal hypoglycaemia, neonatal hyperbilirubinemia, or RDS |