Issue: 2023, Vol. 28, No. 3

А. I. Malyshkina, V. А. Afonina, N. V. Batrak

RISK FACTORS FOR GESTATIONAL DIABETES MELLITUS DEVELOPMENT IN THREATENING LATE MISCAR- RIAGE IN THE SECOND TRIMESTER OF GESTATION

Keywords

gestational diabetes mellitus, risk factors, anxiety, depression, stress

Abstarct

According to statistic data over the past half century the incidence of gestational diabetes mellitus (GDM) increased extremely, and nowadays exceeded 40%. Frequently GDM is developed on the background of pre-existing pregnancy complications and aggravates them or provokes the development of the new ones; it makes the search of risk factors (RF) for HDM development relevant in concomitant complications of pregnancy. Objective – to reveal RF of GDM development in women with threatening late miscarriage (TLM) in the second trimester of gestation. Material and methods. 85 women with threatening miscarriage at the gestation period of 13–22 weeks at the moment of their admission to the hospital were enrolled in the study. 47 women with threatening miscarriage and GDM which was diagnosed at the admission composed the basic group. 38 patients with threatening miscarriage composed the comparison group. Some specially developed questionnaire was used in conducting the survey in all women. The assessment of the level of anxiety and depression was performed by HADS. Results and discussion. Women with GDM which was revealed in the second trimester of pregnancy and with TLM were characterized by older reproductive age (31 (28; 37) and 30 (25; 32) years; р = 0,009), later onset of sexual activity (18 (17; 19) and 17,5 (16; 18) years; р = 0,049), longer period of the onset of sexual activity and the onset of the first pregnancy (6 (3; 9,5) and 5 (2; 7) years; р = 0,038) and respectively, older age of the onset of the first pregnancy (24 (21,5; 29) and 23 (19; 25) years; р = 0,005), higher growth (169 (161; 171) and 163 (161; 167) sm; р = 0,04), higher body mass index (BMI) at the moment of the onset of pregnancy (26,59 (20,22; 30,45) and 19,49 (18,24; 20,37) kg/m 2 ; р = 0,001) and at the moment of the examination (28,44 (23,05; 32,02) and 21,89 (20,34; 26,48) kg/m 2 ; р = 0,002). Risk factors for HDM development in the second trimester of pregnancy in women with TLM were as fol- lows: labile weight (odds ratio (OR) – 3,99; 95% confidence interval (CI) 1,55–10,25; р = 0,004), irregular working hours (OR – 7,24; 95% CI 1,94–27,04; р = 0,003), frequent neuropsychiatric stress (OR – 3,03; 95% CI 1,15–7,98; р = 0,03), sedentary work (OR – 3,01; 95% CI 1,1–8,22; р = 0,03), smoking before pregnancy (OR – 5,28; 95% CI 1,6–17,37; р = 0,006) and in pregnancy (OR – 21,56; 95% CI 1,22–381,21; р = 0,036), presence of somatic pathology (hypertonic disease (OR – 11,31; 95% CI 1,39–92,13; р = 0,02), obesity (OR – 21,56; 95% CI 1,22–381,21; р = 0,036)), burdened family history (arterial hypertension (OR – 5,48; 95% DI 2,01–14,93; р< 0,001) and obesity (OR – 10,0; 95% CI 1,22–82,12; р = 0,032) in first-order relatives; infarction (OR – 3,74; 95% CI 1,23–11,38; р = 0,02), diabetes mellitus (DM) 2 type (OR – 5,33; 95% CI 1,77–16,05; р = 0,003) in second-order relatives, burdened obstetric history (preeclampsia (OR – 4,46; 95% CI 1,17–17,06; р = 0,03), polyhydramnios (OR – 19,1; 95% CI2,4–152,24; р = 0,005), aggravated the course of previous pregnancies, difficulty breathing in the supine position (OR – 18,8; 95% CI5,03– 70,1; p < 0,001), snoring (OR – 5,11; 95% CI 1,8–14,5; р = 0,002), anxiety (OR – 5,81; 95% CI 1,93–17,47; р = 0,002), depression (OR – 3,01; 95% CI 1,1–8,22; р = 0,032). Conclusion. In order to eliminate modified RF at pre-gravidar stage and in pregnancy it is required to reveal them in time and to treat extragenital pathology, to recommend consultations in psychologist and nutritionist, to consult married couples.

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