T.KH. DALAEVA², I.B. FATKULLINA^{1, 2}, V.A. SADIKHOVA³, A.T. SUGUROVA⁴, A.A. ZHDANOVA¹, E.F. SHAIKHLISLAMOVA¹

 ¹Bashkir State Medical University, Ufa

²Republic Clinical Perinatal Center, Ufa

³City Clinical Hospital No. 3, Ufa

⁴Republic Medical Genetic Center, Ufa

Contact details:

Dalaeva T.Kh. — obstetrician-gynecologist

Address: 16 Aurory St., 450092 Ufa, Russian Federation, tel.: +7-917-047-77-75, e-mail: tanzila_dalaeva@mail.ru

Gestational diabetes is defined as glucose intolerance that begins during pregnancy and is associated with complications during pregnancy. Due to the enormous increase in the number of people suffering from diabetes mellitus in the world, there is a natural increase in the number of women of reproductive age with this disease and an increase in the number of pregnant women suffering from other types of diabetes. This is due to the peculiarities of the modern lifestyle: high-calorie diet, lack of physical activity, often leading to obesity, an exponential increase in the incidence of type 2 diabetes, as well as improved diagnosis of the disease. During pregnancy complicated by diabetes mellitus, a key role belongs to motivating patients to comply with recommendations for lifestyle and nutrition changes. Timely initiation of diabetes therapy will reduce the likelihood of complications during pregnancy and unwanted perinatal complications.

The purpose — to present literature data on the impact of diabetes mellitus on the course of pregnancy, maternal and newborn outcomes, as well as methods for preventing complications during pregnancy in this population of women.

Material and methods. A review of scientific papers over the past 5 years was conducted using the resources of the PubMed and eLIBRARY search engines using the above keywords. For this meta-analysis, articles were used that contained experimental and clinical evidence on the most modern issues related to the effect of diabetes mellitus on the course of pregnancy.

Conclusion. Based on the literature analysis, it was concluded that there are many complications associated with diabetes mellitus, and effective control of blood sugar levels and compliance with normoglycemia helps to minimize the risks of pregnancy complications.

Key words: diabetes mellitus, gestational diabetes mellitus, pregnancy, preeclampsia, premature placental abruption, hyperglycemia.

REFERENCES

1. Catov J.M., Margerison-Zilko C. Pregnancy as a window to future health: short-term costs and consequences. Am. J. Obstet. Gynecol, 2016, vol. 215 (4), pp. 406–407.
2. Godfrey K.M., Barker D.J.P. Fetal programming and adult health. Pub. Health Nutr, 2001, vol. 4 (2b), pp. 611–624.
3. Hoffman D.J., Reynolds R.M., Hardy D.B. Developmental origins of health and disease: current knowledge and potential mechanisms. Nutr. Rev, 2017, vol. 75 (12), pp. 951–970.
4. López S.G. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: A World Health Organization Guideline, 2014.
5. Poon L.C. et al. The first-trimester of pregnancy–A window of opportunity for prediction and prevention of pregnancy complications and future life. Diabetes Res. Clin. Practice, 2018, vol. 145, pp. 20–30.
6. Andreeva E. et al. Gestatsionnyy sakharnyy diabet. Diagnostika, lechenie, akusherskaya taktika, poslerodovoe nablyudenie. Klinicheskie rekomendatsii [Gestational diabetes mellitus. Diagnostics, treatment, obstetric tactics, postpartum follow-up. Clinical guidelines], 2020.
7. Sukhikh G.T. et al. Transition to a new level of management of hypertensive and metabolic complications during pregnancy: modern diagnostic criteria for gestational diabetes mellitus. Akusherstvo i ginekologiya, 2013, no. 3, pp. 4–9 (in Russ.).
8. Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr. Rev, 2013, vol. 71 (1), pp. S18–S25.
9. Gutaj P. et al. Determinants of preeclampsia in women with type 1 diabetes. Acta Diabetol, 2017, vol. 54, pp. 1115–1121.
10. Hedderson M.M., Ferrara A. High blood pressure before and during early pregnancy is associated with an increased risk of gestational diabetes mellitus. Diabetes care, 2008, vol. 31 (12), pp. 2362–2367.
11. Lee J. et al. Preeclampsia: A risk factor for gestational diabetes mellitus in subsequent pregnancy. PLoS One, 2017, vol. 12 (5), p. e0178150.
12. Kitzmiller J.L. et al. Managing preexisting diabetes for pregnancy: summary of evidence and consensus recommendations for care. Diabetes care, 2008, vol. 31 (5), pp. 1060–1079.
13. Mañé L. et al. Is fasting plasma glucose in early pregnancy a better predictor of adverse obstetric outcomes than glycated haemoglobin? Eur. J. Obstet. Gynecol. Reprod. Biol, 2019, vol. 234, pp. 79–84.
14. Kattini R., Hummelen R., Kelly L. Early gestational diabetes mellitus screening with glycated hemoglobin: a systematic review. J. Obstet. Gynaecol. Canada, 2020, vol. 42 (11), pp. 1379–1384.
15. Yin B. et al. Association of higher HbA1c within the normal range with adverse pregnancy outcomes: a cross-sectional study. Acta Diabetol, 2021, vol. 58, pp. 1081–1089.
16. Osuagwu U.L. et al. Adverse maternal outcomes of Fijian women with gestational diabetes mellitus and the associated risk factors. Reprod. Sci, 2020, vol. 27 (11), pp. 2029–2037.
17. Zehravi M., Maqbool M., Ara I. Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview. Int. J. Adol. Med. Health, 2021, vol. 33 (6), pp. 339–345.
18. Mustafa M. et al. Early gestational diabetes mellitus (GDM) is associated with worse pregnancy outcomes compared with GDM diagnosed at 24–28 weeks’ gestation despite early treatment. QJM: An Int. J. Med, 2021, vol. 114 (1), pp. 17–24.
19. Boriboonhirunsarn D. et al. Prevalence of early-onset GDM and associated risk factors in a university hospital in Thailand. J. Obstet. Gynaecol, 2021, vol. 41 (6), pp. 915–919.
20. Zheng W. et al. Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study. BMC Pregn. Childbirth, 2021, vol. 21, pp. 1–9.
21. Lewandowska M., Więckowska B., Sajdak S. Pre-pregnancy obesity, excessive gestational weight gain, and the risk of pregnancy-induced hypertension and gestational diabetes mellitus. J. Clin. Med, 2020, vol. 9 (6), p. 1980.
22. Cosson E. et al. Prognosis associated with initial care of increased fasting glucose in early pregnancy: a retrospective study. Diab. Metabol, 2021, vol. 47 (3), p. 101197.
23. Kalok A. et al. Correlation between oral glucose tolerance test abnormalities and adverse pregnancy outcomes in gestational diabetes: a cross-sectional study. Int. J. Environ. Res. Public Health, 2020, vol. 17 (19), p. 6990.
24. Carrasco-Wong I. et al. Placental structure in gestational diabetes mellitus. Biochim. Biophys. Acta (BBA)-Mol. Basis Dis, 2020, vol. 1866 (2), p. 165535.
25. Clyne A.M. Endothelial response to glucose: dysfunction, metabolism, and transport. Biochem. Soc. Transactions, 2021, vol. 49 (1), pp. 313–325.
26. Martin-Aragon Baudel M. et al. Purinergic signaling during hyperglycemia in vascular smooth muscle cells. Front. Endocrinol, 2020, vol. 11, p. 329.
27. Olmos-Ortiz A. et al. Immunoendocrine dysregulation during gestational diabetes mellitus: The central role of the placenta. Int. J. Mol. Sci, 2021, vol. 22 (15), p. 8087.
28. Kapustin R.V. et al. Analysis of risk factors and structure of perinatal losses in pregnant women with diabetes mellitus. Doktor.Ru, 2021, vol. 20, no. 6, pp. 46–52.
29. Stacey T. et al. Gestational diabetes and the risk of late stillbirth: a case–control study from England, UK. BJOG: An Int. J. Obstet. Gynaecol, 2019, vol. 126 (8), pp. 973–982.
30. Mackin S.T. et al. Factors associated with stillbirth in women with diabetes. Diabetol, 2019, vol. 62, pp. 1938–1947.
31. Kapustin R. et al. Maternal serum nitrotyrosine, 8-isoprostane and total antioxidant capacity levels in pre-gestational or gestational diabetes mellitus. Gynecol. Endocrinol, 2020, vol. 36 (1), pp. 36–42.