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首页> 外文期刊>Open Journal of Obstetrics and Gynecology >Effect of maternal alcohol consumption on gestational diabetes detection and mother-infant’s outcomes in Kinshasa, DR Congo
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Effect of maternal alcohol consumption on gestational diabetes detection and mother-infant’s outcomes in Kinshasa, DR Congo

机译:刚果民主共和国金沙萨孕妇饮酒对妊娠糖尿病检测和母婴结局的影响

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Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol consumption during pregnancy, and seeing whether this consumption influences GDM detection and maternal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pregnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O’Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and general characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Metformin, and if necessary with insulin. For other (normal) women data remained blinded until confinement. Maternal and infant’s adverse outcomes such as maternal urinary infection, preeclampsia, cesarean section, intrauterine growth retardation, birth weight percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hypoglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol consumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more frequent (p = 0.02) among drinkers. GDM’s prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alcohol consumers than in abstainers. Risk of this outcome was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 - 13.544). Conclusions: The prevalence of alcohol consumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. Influence of alcohol consumption on birth weight mostly in setting of familial history of hypertension remains to be addressed.
机译:目的:由于有人建议适度饮酒会增加胰岛素敏感性,这可能有益于妊娠糖尿病(GDM),该研究旨在评估怀孕期间的饮酒量,并观察这种饮酒是否会影响GDM的检测和母婴围产期结局。研究设计:排除患有已知糖尿病和多胎妊娠的妇女。从2010年3月1日至2010年10月31日,在刚果金索萨大学诊所接受所有产前保健的所有其他孕妇,在妊娠24周时被邀请参加O'Sullivan血糖测试,如果符合资格,则参加100-克口服葡萄糖耐量试验。记录了饮酒,GDM的危险因素以及年龄,胎次,体重,BMI,脂肪量等一般特征。诊断为GDM的人首先要通过饮食和运动治疗,然后再用二甲双胍治疗,必要时再用胰岛素治疗。对于其他(正常)女性,数据一直处于封闭状态。母婴的不良结局,例如母体尿路感染,先兆子痫,剖宫产,宫内发育迟缓,环境中出生体重百分位数为90),第一分钟的Apgar评分<7,肩难产或其他出生损伤,新生儿低血糖和胎儿酒精根据GDM诊断以及酒精状态对综合症(FAS)进行比较和分析。结果:多达240名孕妇被接受参加研究。饮酒涉及78名妇女(32.5%),其中大多数(61 = 25.42%)是重度消费者。消费者和非消费者中,GDM和身体和血糖特征的危险因素相似(p不显着),但家族中HTA的病史在饮酒者中更为频繁(p = 0.02)。 GDM的患病率为9 %。在任何亚组中,没有不良后果更突出,除了在第一分钟的GDM母亲的新生儿中,Apgar得分<7较常见(p = 0.038)。没有FAS,也没有诊断出肩难产或新生儿低血糖。考虑酒精状态时,发现饮酒≥3800 g的人比戒酒的人更频繁(p = 0.0284)。存在家族高血压病史时,发生这种结局的风险要高出三倍(优势比2.694; CI:0.536-13.544)。结论:我们系列孕妇的饮酒率(32.5%)似乎不影响GDM的检测(9%)。未诊断出FAS。 GDM和非GDM之间不良后果之间没有显着差异,这可以归因于对GDM妇女的大量随访。在高血压家族史中,饮酒对出生体重的影响尚待解决。

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