Aleksandra Z Jotic, Milica M Stoiljkovic, Tanja J Milicic, Katarina S Lalic, Ljiljana Z Lukic, Marija V Macesic, Jelena N Stanarcic Gajovic, Mina M Milovancevic, Marko H Obradovic, Miroslava G Gojnic, Djurdja P Rafailovic, Nebojsa M Lalic
{"title":"早发性2型糖尿病孕妇的综合母胎结局预测因素：一项横断面研究","authors":"Aleksandra Z Jotic, Milica M Stoiljkovic, Tanja J Milicic, Katarina S Lalic, Ljiljana Z Lukic, Marija V Macesic, Jelena N Stanarcic Gajovic, Mina M Milovancevic, Marko H Obradovic, Miroslava G Gojnic, Djurdja P Rafailovic, Nebojsa M Lalic","doi":"10.1007/s13300-025-01713-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The most common form of pregestational diabetes in pregnancy is type 2 diabetes, requiring strict metabolic monitoring owing to the risk of adverse pregnancy outcomes. Our study aimed to identify predictors of composite maternal outcome (CMO) and fetal outcome (CFO) separately in pregnant women with early-onset type 2 diabetes (PwEOT2D).</p><p><strong>Methods: </strong>The cross-sectional pilot study included 60 PwEOT2D by recording age, socioeconomic determinants, preconception body mass index (pBMI), preconception (pHbA1c) and trimester-specific glycated hemoglobin (HbA1c), gestational weight gain (GWG), and pregnancy outcomes. We defined CMO as at least one of the following: gestational hypertension, preeclampsia, eclampsia, preterm delivery, or emergency section. CFO included at least one of the following: small or large for gestational age, macrosomia, neonatal hypoglycemia, or admission to the neonatal intensive care unit.</p><p><strong>Results: </strong>CMO was detected in 55% and CFO in 35% of PwEOT2D. The majority of PwEOT2D with CMO lived in suburban areas (73.1%), while those without CMO mostly lived in rural areas (51.9%, p = 0.014). Moreover, PwEOT2D with CMO had comparable pBMI to those without CMO (31.45 ± 6.27 versus 28.99 ± 6.28 kg/m<sup>2</sup>, p = 0.136). However, PwEOT2D with CMO had higher pHbA1c (7.28 ± 0.95 versus 6.46 ± 0.96%, p = 0.002) and first trimester HbA1c (7.24 ± 1.08 versus 6.42 ± 0.97%, p = 0.003). Similarly, PwEOT2D with CFO had higher pHbA1c (7.84 ± 0.95 versus 6.41 ± 0.67%, p < 0.001) and first trimester (7.29 ± 1.07 versus 6.65 ± 1.07%, p = 0.032) and second trimester HbA1c (6.45 ± 0.87 versus 5.96 ± 0.82%, p = 0.038). Additionally, GWG was higher in the second (4.38 ± 2.01 versus 3.33 ± 1.61 kg, p = 0.032) and third trimester (5.66 ± 2.93 versus 3.89 ± 2.61 kg, p = 0.002) compared with those without CMO. Regression analysis identified pHbA<sub>1</sub>c, first trimester of pregnancy, and community type as predictors of CMO, while pHbA1c and the occurrence of CMO were predictors of CFO.</p><p><strong>Conclusions: </strong>Our results imply that preconception and first trimester of pregnancy HbA<sub>1</sub>c, as well as community disparities, are predictors of CMO, while the predictors of CFO were only preconception HbA1c and the occurrence of CMO in pregnant women with EOT2D. Therefore, tailoring preventive strategies, followed by achieving and sustaining trimester-specific metabolic control, might improve pregnancy outcomes in women with EOT2D.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors of Composite Maternal and Fetal Outcomes among Pregnant Women with Early-Onset Type 2 Diabetes: A Cross-Sectional Study.\",\"authors\":\"Aleksandra Z Jotic, Milica M Stoiljkovic, Tanja J Milicic, Katarina S Lalic, Ljiljana Z Lukic, Marija V Macesic, Jelena N Stanarcic Gajovic, Mina M Milovancevic, Marko H Obradovic, Miroslava G Gojnic, Djurdja P Rafailovic, Nebojsa M Lalic\",\"doi\":\"10.1007/s13300-025-01713-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The most common form of pregestational diabetes in pregnancy is type 2 diabetes, requiring strict metabolic monitoring owing to the risk of adverse pregnancy outcomes. Our study aimed to identify predictors of composite maternal outcome (CMO) and fetal outcome (CFO) separately in pregnant women with early-onset type 2 diabetes (PwEOT2D).</p><p><strong>Methods: </strong>The cross-sectional pilot study included 60 PwEOT2D by recording age, socioeconomic determinants, preconception body mass index (pBMI), preconception (pHbA1c) and trimester-specific glycated hemoglobin (HbA1c), gestational weight gain (GWG), and pregnancy outcomes. We defined CMO as at least one of the following: gestational hypertension, preeclampsia, eclampsia, preterm delivery, or emergency section. CFO included at least one of the following: small or large for gestational age, macrosomia, neonatal hypoglycemia, or admission to the neonatal intensive care unit.</p><p><strong>Results: </strong>CMO was detected in 55% and CFO in 35% of PwEOT2D. The majority of PwEOT2D with CMO lived in suburban areas (73.1%), while those without CMO mostly lived in rural areas (51.9%, p = 0.014). Moreover, PwEOT2D with CMO had comparable pBMI to those without CMO (31.45 ± 6.27 versus 28.99 ± 6.28 kg/m<sup>2</sup>, p = 0.136). However, PwEOT2D with CMO had higher pHbA1c (7.28 ± 0.95 versus 6.46 ± 0.96%, p = 0.002) and first trimester HbA1c (7.24 ± 1.08 versus 6.42 ± 0.97%, p = 0.003). Similarly, PwEOT2D with CFO had higher pHbA1c (7.84 ± 0.95 versus 6.41 ± 0.67%, p < 0.001) and first trimester (7.29 ± 1.07 versus 6.65 ± 1.07%, p = 0.032) and second trimester HbA1c (6.45 ± 0.87 versus 5.96 ± 0.82%, p = 0.038). Additionally, GWG was higher in the second (4.38 ± 2.01 versus 3.33 ± 1.61 kg, p = 0.032) and third trimester (5.66 ± 2.93 versus 3.89 ± 2.61 kg, p = 0.002) compared with those without CMO. Regression analysis identified pHbA<sub>1</sub>c, first trimester of pregnancy, and community type as predictors of CMO, while pHbA1c and the occurrence of CMO were predictors of CFO.</p><p><strong>Conclusions: </strong>Our results imply that preconception and first trimester of pregnancy HbA<sub>1</sub>c, as well as community disparities, are predictors of CMO, while the predictors of CFO were only preconception HbA1c and the occurrence of CMO in pregnant women with EOT2D. Therefore, tailoring preventive strategies, followed by achieving and sustaining trimester-specific metabolic control, might improve pregnancy outcomes in women with EOT2D.</p>\",\"PeriodicalId\":11192,\"journal\":{\"name\":\"Diabetes Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-03-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13300-025-01713-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13300-025-01713-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
妊娠期最常见的妊娠糖尿病是2型糖尿病，由于有不良妊娠结局的风险，需要严格的代谢监测。本研究旨在分别确定早发性2型糖尿病（PwEOT2D）孕妇的综合产妇结局（CMO）和胎儿结局（CFO）的预测因素。方法：通过记录年龄、社会经济因素、孕前体重指数（pBMI）、孕前（pHbA1c）和妊娠期特异性糖化血红蛋白（HbA1c）、妊娠体重增加（GWG）和妊娠结局，对60名PwEOT2D患者进行横断面试点研究。我们将CMO定义为以下至少一种：妊娠期高血压、先兆子痫、子痫、早产或急症。CFO包括以下至少一项：胎龄小或大、巨大儿、新生儿低血糖或入住新生儿重症监护病房。结果：55%的PwEOT2D患者检出CMO， 35%的PwEOT2D患者检出CFO。有CMO的PwEOT2D多居住在郊区（73.1%），无CMO的PwEOT2D多居住在农村（51.9%,p = 0.014）。此外，合并CMO的PwEOT2D的pBMI与未合并CMO的PwEOT2D相当（31.45±6.27 vs 28.99±6.28 kg/m2, p = 0.136）。然而，PwEOT2D合并CMO的pHbA1c（7.28±0.95比6.46±0.96%,p = 0.002）和妊娠早期HbA1c（7.24±1.08比6.42±0.97%,p = 0.003）较高。同样，PwEOT2D合并CFO的pHbA1c（7.84±0.95 vs 6.41±0.67%）、p1c、妊娠早期和社区类型是CMO的预测因子，而pHbA1c和CMO的发生是CFO的预测因子。结论：我们的研究结果表明，孕前和妊娠早期HbA1c以及社区差异是CMO的预测因子，而CFO的预测因子仅为孕前HbA1c和EOT2D孕妇CMO的发生。因此，定制预防策略，然后实现和维持妊娠期特异性代谢控制，可能会改善EOT2D妇女的妊娠结局。
Predictors of Composite Maternal and Fetal Outcomes among Pregnant Women with Early-Onset Type 2 Diabetes: A Cross-Sectional Study.
Introduction: The most common form of pregestational diabetes in pregnancy is type 2 diabetes, requiring strict metabolic monitoring owing to the risk of adverse pregnancy outcomes. Our study aimed to identify predictors of composite maternal outcome (CMO) and fetal outcome (CFO) separately in pregnant women with early-onset type 2 diabetes (PwEOT2D).
Methods: The cross-sectional pilot study included 60 PwEOT2D by recording age, socioeconomic determinants, preconception body mass index (pBMI), preconception (pHbA1c) and trimester-specific glycated hemoglobin (HbA1c), gestational weight gain (GWG), and pregnancy outcomes. We defined CMO as at least one of the following: gestational hypertension, preeclampsia, eclampsia, preterm delivery, or emergency section. CFO included at least one of the following: small or large for gestational age, macrosomia, neonatal hypoglycemia, or admission to the neonatal intensive care unit.
Results: CMO was detected in 55% and CFO in 35% of PwEOT2D. The majority of PwEOT2D with CMO lived in suburban areas (73.1%), while those without CMO mostly lived in rural areas (51.9%, p = 0.014). Moreover, PwEOT2D with CMO had comparable pBMI to those without CMO (31.45 ± 6.27 versus 28.99 ± 6.28 kg/m2, p = 0.136). However, PwEOT2D with CMO had higher pHbA1c (7.28 ± 0.95 versus 6.46 ± 0.96%, p = 0.002) and first trimester HbA1c (7.24 ± 1.08 versus 6.42 ± 0.97%, p = 0.003). Similarly, PwEOT2D with CFO had higher pHbA1c (7.84 ± 0.95 versus 6.41 ± 0.67%, p < 0.001) and first trimester (7.29 ± 1.07 versus 6.65 ± 1.07%, p = 0.032) and second trimester HbA1c (6.45 ± 0.87 versus 5.96 ± 0.82%, p = 0.038). Additionally, GWG was higher in the second (4.38 ± 2.01 versus 3.33 ± 1.61 kg, p = 0.032) and third trimester (5.66 ± 2.93 versus 3.89 ± 2.61 kg, p = 0.002) compared with those without CMO. Regression analysis identified pHbA1c, first trimester of pregnancy, and community type as predictors of CMO, while pHbA1c and the occurrence of CMO were predictors of CFO.
Conclusions: Our results imply that preconception and first trimester of pregnancy HbA1c, as well as community disparities, are predictors of CMO, while the predictors of CFO were only preconception HbA1c and the occurrence of CMO in pregnant women with EOT2D. Therefore, tailoring preventive strategies, followed by achieving and sustaining trimester-specific metabolic control, might improve pregnancy outcomes in women with EOT2D.
期刊介绍：
Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
