โรคเบาหวานขณะตั้งครรภ์ในโรงพยาบาลโพธาราม : ความชุก ปัจจัยเสี่ยงทางคลินิกและผลลัพธ์การตั้งครรภ์

บทคัดย่อ

Objective : To determine prevalence of gestational diabetes mellitus (GDM), clinical risk factors and pregnancy outcomes of pregnant women at Photharam hospital.

Materials and methods : This retrospective descriptive study was conducted by reviewing medical records of 1,096 pregnant women who attended the antenatal care clinic and delivered at Photharam hospital from October 2008 to September 2009. Glucose challenge test (GCT), 50-g glucose oral load with 1-hr plasma glucose measurement was performed in GDM high risk pregnancies. If GCT was positive, 100-g 3-hr oral glucose tolerance test (OGTT) was done to confirm the final diagnosis. All relevant data including demographic information, previous obstetrics history, risk factors for GDM and pregnancy outcomes were collected for further statistical analysis.

Results : 414 out of 1,096 pregnant women with clinical risk factors for GDM were screened with225 positive 50-g 1-hr GCT. 59 cases of GDM were detected by 100-g 3-hr OGTT with the prevalence of 5.38%. As a result, the sensitivity, specificity, positive predictive value and negative predictive value were 100%, 53.24%, 26.22% and 0% respectively. GDM are more likely to associate pregnant women who had plasma glucose higher than 180 mg/dL (p-value 0.002) and ≥ 3 risk factors (p-value = 0.000). Advance maternal age was the most common clinical risk factor for GDM (p-valve = 0.001).

Conclusion : The selective GCT screening strategy was highly effective and revealed 5.38% of GDM prevalence. Its impact on obstetric complication and pregnancy outcome was inconclusive due to the small number of the studied population. Careful history reviewing and completeness of medical records play an important role in identifying GDM risk factors.