Incidence of gestational diabetes and birth complications in Switzerland: screening in 1042 pregnancies

Abstract

To evaluate the incidence of gestational diabetes mellitus (GDM), gestational glucose intolerance (GGI), and birth major complications, a population of 1042 pregnant women was screened after the end of the second trimester with a two-step screening method. Patients with a positive 50-g screening test (plasma glucose ≥7.8 mmol/l at 1 h) underwent a 3-h standard 100-g oral glucose tolerance test. Clinical records of patients and newborns were analysed and compared to normotolerant patients group. GDM was found in 4.8% and GGI in 2.6% of all screened women of this study population. The patient group with GDM significantly differed from control, with a higher proportion of Asiatic women (32.0% versus 2.9%, p = 0.001) and high prevalence of previous GDM (26.0% versus 0.0%, p < 0.001). Major neonatal complications occurred more frequently in the dysmetabolic groups compared to normotolerant group. Macrosomia was not noted in our population. Asiatic origin and previous GDM were strongly associated with an increased incidence of GDM in multivariate analysis. This study represents the first epidemiological evaluation of GDM/GGI in Switzerland, with a two-step screening method. Incidence of GDM and GGI as well as birth complications resulted significant in our country.

Chinese abstract

为了估计妊娠期糖尿病（gestational diabetes mellitus，GDM）、妊娠期葡萄糖耐受不良（gestational glucose intolerance，GGI）和分娩主要并发症的发生率，本研究采用两部筛选法共筛选了1042名孕中期之后的孕妇。50g口服葡萄糖筛选试验阳性患者（1小时血糖≥7.8 mmol/l）进行标准的3小时100g口服葡萄糖耐量试验。糖代谢异常组的孕妇及新生儿的临床指标与对照组（糖耐量正常孕妇）进行分析比较。在本研究人群中有4.8%发生GDM，2.6%发生GGI。与对照组相比，GDM组中亚洲女性的比例显著升高（32.0% vs 2.9%, p=0.001），既往有过GDM女性的比例也显著升高（26.0% vs 0.0%, p<0.001）。与糖耐量正常组相比，糖代谢紊乱组主要新生儿疾病的发生率更高。本人群未记录巨大儿的发生率。多因素分析显示GDM发病率升高与孕妇为亚洲女性和既往有GDM病史密切相关。本研究是瑞士第一次应用两步筛选法对GDM/GGI进行流行病学评价，GDM、GGI及分娩并发症的发生率在瑞士是需引起注意的。

• Birth complications
• diabetes
• GDM
• pregnancy

Acknowledgements

We thank Dr Cosette Pharisa for newborn-data interpretation.