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Factors associated with patients with gestational diabetes in Japan being at increased risk of requiring intensive care
Author(s) -
Yamashita Hiroshi,
Yasuhi Ichiro,
Kugishima Yukari,
Sugimi So,
Umezaki Yasushi,
Suga Sachie,
Fukuda Masashi,
Kusuda Nobuko
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12354
Subject(s) - medicine , gestational diabetes , diabetes mellitus , intensive care , intensive care medicine , obstetrics , gestation , pregnancy , endocrinology , genetics , biology
Objective To investigate factors associated with high‐risk gestational diabetes ( GDM ) among patients with GDM . Methods The present retrospective study included women with singleton pregnancies diagnosed with GDM using International Association of Diabetes and Pregnancy Study Group criteria at a single tertiary perinatal care center in Japan between July 1, 2010, and October 31, 2014. High‐risk GDM was defined as patients who required at least 20 units of insulin therapy a day, delivering a large‐for‐gestational age neonate regardless of insulin therapy, or both. Maternal characteristics and diagnostic test results were investigated to identify associations with the high‐risk criteria, and odds ratios ( OR s) with 95% confidence intervals ( CI s) were calculated. Results Among 217 patients, 95 (43.8%) were categorized as high risk. After adjusting for confounders, a fasting plasma glucose level at diagnosis of at least 4.66 mmol/L (adjusted OR 2.88, 95% CI 1.51–5.58) and pre‐pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters) of at least 24 (adjusted OR 3.27, 95% CI 1.60–6.90) were independently associated with meeting the high‐risk criteria. Conclusion Among Japanese patients with GDM , pre‐pregnancy body mass index and fasting plasma glucose levels could be used to identify high‐risk patients requiring intensive care during pregnancy.