Browsing by Author "Muratova, Aida"

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    EVALUATION OF FETAL AND NEONATAL OUTCOMES IN PATIENTS WITH GLUCOSE METABOLISM DISORDERS IN PREGNANCY
    (Nazarbayev University School of Medicine, 2024) Muratova, Aida
    Background. Glucose metabolism disorders, encompassing gestational diabetes mellitus (GDM) and pregestational (PGDM) Type 1 and Type 2 diabetes, represent significant health challenges during pregnancy. The interplay between altered maternal glucose regulation and fetal development can lead to various fetal, neonatal, and long-term adverse outcomes, including stillbirth, premature delivery, macrosomia, congenital defects, babies born with hypoglycemia, respiratory distress syndrome, type 2 diabetes, or cardiomyopathy. This study aims to investigate the associations of fetal and neonatal outcomes with glucose metabolism disorders during pregnancy. Methods. The data gathered from the medical records of 281 women who delivered at the Department of Obstetrics and Gynaecology, University Medical Centre, National Research Centre for Mother and Child Health in Nur-Sultan, Kazakhstan, in the period between 2013 and 2017 were analyzed. The study included the records of 281 pregnant women with glucose metabolism disorders and birth at or after 24 gestational weeks of a fetus weighing >500 grams. The participants were divided into 4 groups depending on the type of diabetes: PGDM Type 1, PGDM Type 2, GDM with insulin, and GDM without insulin. The data were examined by applying descriptive, bivariable, and multivariable analyses. Results. Out of 281 women who participated in the study 55 (19.6%) had PGDM Type 1, 36 (12.8%) had PGDM Type 2, 57 (20.3%) had GDM treated with insulin, and 133 (47.3%) had GDM without insulin. There were significant differences between the groups in the frequency of outcomes like birth before 37 weeks, birth weight more than 4000 g, presence of pathologic CTG, and other diseases of the newborn. The occurrence of preterm birth was highest in PGDM Type 1 34.6% (OR 4.18 [1.77-9.92]) compared to the other types. The frequency of macrosomia (birthweight >4000 g) was highest in GDM with insulin 50.9% (OR 2.02 [1.12-3.63]). The percentage of pathologic CTG was greatest in PGDM Type 1 34.5% (OR 3.13 [1.39-7.03]). The prevalence of other diseases of the newborn was highest in PGDM Type 1 33.3% (OR 2.72 [1.16-6.39]). Conclusion. The results of this study illustrate that the vast majority of participants were diagnosed with gestational diabetes mellitus. The occurrence of prematurity, pathological CTG, and other diseases of the newborn were higher in PGDM Type 1, while macrosomia (birthweight >4000 g) was predominant in GDM with insulin and PGDM Type 2 diabetes groups.