임신성 당뇨 선별검사에서 양성이었으나 확진되지 않은 산모에서 태어난 후기 미숙아들의 예후 (Late Preterm Infants’ Outcome Born from Mothers with Positive Screening but Negative Diagnostic Test for Gestational Diabetes)

서지정보

· 발행기관 : 대한주산의학회
· 수록지 정보 : Perinatology / 26권 / 4호 / 377 ~ 377페이지
· 저자명 : 이정민, 서보선, 김은선

초록

Purpose

The aim of the study is to determine whether late preterm infants from normal oral GTT (glucose tolerance test) but positive GCT (glucose challenge test) mothers are associated with adverse postnatal outcome.








Methods

A retrospective study was performed from singleton infants who were born at 34+0-36+6 weeks between January 2008 and December 2012 and prenatally checked at CHA Gangnam Medical Center. Infants were categorized into three groups according to the results of 50 g oral GCT and 100 g oral GTT; NG group (normal glucose tolerance group, n=603) vs. GIG group (gestational impaired glucose tolerance group; infants of normal oral GTT but positive GCT mothers, n=77) vs. GDM group (gestational diabetes group, n=52). Neonatal outcomes were compared among the three groups.








Results

GIG group showed significantly increased incidence of jaundice compared to NG group (9.6% vs. 19.5%, P=0.031). The number of old mothers (≥35 years at delivery) was significantly higher in GIG group compared to NG group (27.5% vs. 33.8%, P=0.006). After stratification by maternal age, GIG group showed significantly increased respiratory diseases compared to NG group (44% vs. 65.4%, P=0.04). Hypocalcemia and feeding problem increased across the groups (NG vs. GIG vs. GDM; 13.3% vs. 26.9% vs. 32.0%, P= 0.024; 6.0% vs. 11.5% vs. 20.0%, P=0.05, respectively).








Conclusion

Late preterm infants of normal oral GTT but positive GCT mothers, especially in older mother, have increased risk of postnatal morbidities such as respiratory distress, jaundice, hypocalcemia or feeding intolerance. Thus, careful follow up may be needed in this group since antepartum period.

영어초록

Purpose

The aim of the study is to determine whether late preterm infants from normal oral GTT (glucose tolerance test) but positive GCT (glucose challenge test) mothers are associated with adverse postnatal outcome.




Methods

A retrospective study was performed from singleton infants who were born at 34+0-36+6 weeks between January 2008 and December 2012 and prenatally checked at CHA Gangnam Medical Center. Infants were categorized into three groups according to the results of 50 g oral GCT and 100 g oral GTT; NG group (normal glucose tolerance group, n=603) vs. GIG group (gestational impaired glucose tolerance group; infants of normal oral GTT but positive GCT mothers, n=77) vs. GDM group (gestational diabetes group, n=52). Neonatal outcomes were compared among the three groups.




Results

GIG group showed significantly increased incidence of jaundice compared to NG group (9.6% vs. 19.5%, P=0.031). The number of old mothers (≥35 years at delivery) was significantly higher in GIG group compared to NG group (27.5% vs. 33.8%, P=0.006). After stratification by maternal age, GIG group showed significantly increased respiratory diseases compared to NG group (44% vs. 65.4%, P=0.04). Hypocalcemia and feeding problem increased across the groups (NG vs. GIG vs. GDM; 13.3% vs. 26.9% vs. 32.0%, P= 0.024; 6.0% vs. 11.5% vs. 20.0%, P=0.05, respectively).




Conclusion

Late preterm infants of normal oral GTT but positive GCT mothers, especially in older mother, have increased risk of postnatal morbidities such as respiratory distress, jaundice, hypocalcemia or feeding intolerance. Thus, careful follow up may be needed in this group since antepartum period.

참고자료

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