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open access

Vol 93, No 12 (2022)
Research paper
Published online: 2022-03-07
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Hyperglycemia in pregnancy — prevalence and perinatal outcomes. A retrospective multicenter cohort study in Poland

Dorota A. Bomba-Opon1, Bartosz Godek1, Lukasz Czekaj2, Hubert Huras3, Karolina Jakubiec-Wisniewska3, Krzysztof Janowiec3, Bozena Leszczynska-Gorzelak4, Magdalena Slodzinska4, Mariusz Zimmer5, Wiktor Bek5, Wojciech Rokita†6, Anna Zmelonek-Znamirowska6, Jaroslaw Kalinka7, Pawel Biesiada7, Patrycja Stanczyk7, Wojciech Cnota8, Marzena Malec8, Piotr Laudanski19, Rafal Zadykowicz910, Miroslaw Wielgos1
DOI: 10.5603/GP.a2021.0257
·
Pubmed: 35315020
·
Ginekol Pol 2022;93(12):1006-1012.
Affiliations
  1. 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
  2. Bilnader Group, Gdansk, Poland
  3. Department of Obstetrics and Perinatology Jagielonian University, Cracow, Poland
  4. Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
  5. 2nd Department of Obstetrics and Gynecology, Medical University of Wroclaw, Poland
  6. Department of Obstetrics and Gynecology, The Institute of Medical Sciences Jan Kochanowski University, Kielce, Poland
  7. Department of Perinatology, Medical University of Lodz, Poland
  8. Department of Gynaecology and Obstetrics, Medical University of Silesia, Poland
  9. Department of Perinatology, Medical University of Bialystok, Poland
  10. Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland

open access

Vol 93, No 12 (2022)
ORIGINAL PAPERS Obstetrics
Published online: 2022-03-07

Abstract

Objectives: Hyperglycemia in pregnancy (HIP) is one of the most common complications of pregnancy. Recently adopted new criteria for the diagnosis of HIP as well as the greater prevalence of risk factors could have a significant impact on HIP prevalence. The objective of the study was to assess the rates of HIP and the associated complications. Material and methods: This was a retrospective analysis of clinical records from pregnant women who delivered in eight tertiary hospitals in Poland in 2016. Results: The number of pregnant women with hyperglycemia totaled 1280 (7.25%), including gestational diabetes mellitus (GDM) in 1169 (6.62%) women and pregestational diabetes mellitus (PGDM) in 111 (0.63%). In addition to dietary modifications, 477 (41% of the GDM group) women received medical treatment (GDMG2). In women with PGDM multiple daily insulin injections (MDI) were used in 53 (47.7%) cases, continuous subcutaneous insulin infusions (CSII) in 57 (51.3%) cases and one woman was treated with metformin. The rate of cesarean sections was 69.4% and 62.9% for PGDM and GDM, respectively. Large-for-gestational-age (LGA) infants accounted for 38% and 21% of births in the PGDM and GDM groups, respectively. Of note are high rates of hyperbilirubinemia in infants born to mothers treated with insulin (13.5% for PGDM and 14.4% for GDMG2) vs infants born to mothers with diet (GDMG1) (3.4%). Conclusions: In Poland, the prevalence of HIP has nearly doubled in the past twenty years. Even with appropriate management, HIP is a significant risk factor for a cesarean section delivery, bearing an LGA infant and adverse neonatal outcomes.

Abstract

Objectives: Hyperglycemia in pregnancy (HIP) is one of the most common complications of pregnancy. Recently adopted new criteria for the diagnosis of HIP as well as the greater prevalence of risk factors could have a significant impact on HIP prevalence. The objective of the study was to assess the rates of HIP and the associated complications. Material and methods: This was a retrospective analysis of clinical records from pregnant women who delivered in eight tertiary hospitals in Poland in 2016. Results: The number of pregnant women with hyperglycemia totaled 1280 (7.25%), including gestational diabetes mellitus (GDM) in 1169 (6.62%) women and pregestational diabetes mellitus (PGDM) in 111 (0.63%). In addition to dietary modifications, 477 (41% of the GDM group) women received medical treatment (GDMG2). In women with PGDM multiple daily insulin injections (MDI) were used in 53 (47.7%) cases, continuous subcutaneous insulin infusions (CSII) in 57 (51.3%) cases and one woman was treated with metformin. The rate of cesarean sections was 69.4% and 62.9% for PGDM and GDM, respectively. Large-for-gestational-age (LGA) infants accounted for 38% and 21% of births in the PGDM and GDM groups, respectively. Of note are high rates of hyperbilirubinemia in infants born to mothers treated with insulin (13.5% for PGDM and 14.4% for GDMG2) vs infants born to mothers with diet (GDMG1) (3.4%). Conclusions: In Poland, the prevalence of HIP has nearly doubled in the past twenty years. Even with appropriate management, HIP is a significant risk factor for a cesarean section delivery, bearing an LGA infant and adverse neonatal outcomes.

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Keywords

hyperglycemia in pregnancy; HIP; gestational diabetes mellitus; GDM; pregnancy; cesarean section; large for gestational age; LGA

About this article
Title

Hyperglycemia in pregnancy — prevalence and perinatal outcomes. A retrospective multicenter cohort study in Poland

Journal

Ginekologia Polska

Issue

Vol 93, No 12 (2022)

Article type

Research paper

Pages

1006-1012

Published online

2022-03-07

Page views

4041

Article views/downloads

804

DOI

10.5603/GP.a2021.0257

Pubmed

35315020

Bibliographic record

Ginekol Pol 2022;93(12):1006-1012.

Keywords

hyperglycemia in pregnancy
HIP
gestational diabetes mellitus
GDM
pregnancy
cesarean section
large for gestational age
LGA

Authors

Dorota A. Bomba-Opon
Bartosz Godek
Lukasz Czekaj
Hubert Huras
Karolina Jakubiec-Wisniewska
Krzysztof Janowiec
Bozena Leszczynska-Gorzelak
Magdalena Slodzinska
Mariusz Zimmer
Wiktor Bek
Wojciech Rokita†
Anna Zmelonek-Znamirowska
Jaroslaw Kalinka
Pawel Biesiada
Patrycja Stanczyk
Wojciech Cnota
Marzena Malec
Piotr Laudanski
Rafal Zadykowicz
Miroslaw Wielgos

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