Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2019
Thesis Language: Turkish
Student: Dr. Alp Kazancıoğlu
Supervisor: ESİN KOÇ
Open Archive Collection: AVESIS Open Access Collection
Abstract:Hyperglycemia that does not meet the diagnostic criteria of gestational diabetes affects a significant group of pregnant women and leads to many neonatal complications. Our aim in this study is to see if there is a statistically significant difference between the OGTT glucose level of pregnant women who do not meet the diagnostic criteria of GDM and their babies‘ neonatal complications and to see if the plasma glucose levels can be used to predict the complication risk. A group of pregnant women who were not diagnosed with GDM based on the recommendations by IADPSG 2010 were followed at Gazi University Hospital. Primary complications were birth weight above the 90th percentile for gestational age (LGA), neonatal hypoglycemia and cesarean section due to macrosomia. Secondary complications were below the 10th percentile for gestational age (SGA), premature delivery (before 37 weeks of gestation), need for intensive neonatal care (polycythemia, hyperbilirubinemia, respiratory problems, congenital malformations, neonatal asphyxia). A total of 354 pregnant women and their babies were included in the study. In comparative analysis the following complications were analyzed; LGA, hypoglycemia, cesarean section due to macrosomia, premature delivery and polycythemia were found to have a significant association with high plasma glucose levels. However, there was no significant association between hyperbilirubinemia, need for intensive neonatal care and SGA. In multivariate regression analysis, fasting plasma glucose level was found to have a significant effect on polycythemia of OGTT, 1 st hour plasma glucose level on LGA and hypoglycemia, 2 nd hours plasma glucose level on prematurity. The pregravid body mass index (BMI) of the mothers of the babies with LGA and hypoglycemia were found to be significantly higher. No significant specificity and sensitivity levels were found to predict the association between the risk of complications and the OGTT plasma glucose levels after ROC analysis. 67 Infants with hyperglycemic mothers are at increased risk of neonatal complications, even if their mothers are not diagnosed with GDM. The risk of complications can be reduced by an appropriate BMI before pregnancy and weight gain in pregnancy and by reducing the plasma glucose level during pregnancy of hyperglycemic mothers.