양수과다증이 임신성 당뇨 산모의 임신 결과에 미치는 영향 = The Effect of Hydramnios on the Outcomes of Pregnancies Complicated with Gestational Diabetes Mellitus

다국어 초록 (Multilingual Abstract)

Objective : To determine whether hydramnios occurring in pregnant women complicated with gestational diabetes mellitus (GDM) affects maternal and neonatal outcomes. Methods : We evaluated 277 pregnant women with singleton pregnancies and GDM diagnosed by the National Diabetes Data Group (NDDG) criteria. The study group was consisted of 23 pregnant women diagnosed as hydramnios (Amniotic fluid index ; AFI>24㎝) by ultrasonography, and the control group was consisted of 254 pregnant women with normal AFI (10-24㎝). REtrospective review of maternal and neconatal outcomes in these women was performed. Student t-test, chi-square test, Fisher`s exact test, and logistic regression analysis were used for statistics. Results : There were no significant differences in the maternal age and parity between the two groups. The frequency of preterm labor was higher in the study group compared to the control group (4.3% vs. 34.8%, p<0.001). The frequencies of cesarean delivery due to cephalopelvic disproportion or failure to progress, preeclampsia, and placental abruption were not significantly different between the two groups. The study group showed significantly shorter gestational age (38.2±1.4 weeks vs. 36.7±2.5 weeks, p<0.05) and heavier neonatal birth weight at delivery (3,405.,±595.2 gm vs. 3,701.3±757.9 gm, p=0.026). The frequencies of preterm birth (5.1% vs. 39.1%, p<0.01), macrosomia (13.0% vs. 34.8%, p<0.001), admission to neonatal intensive care unit (7.1% vs. 34.8%, p=0.050), neonatal respiratory complications (3.9% vs. 21.7%, p<0.001), and hyperbilirubinemia (11.0% vs. 47.8%, p<0.001) were higher in the study group even after logistic regression analysis for controlling gestational age. Conclusion : Hydramnios occurring in pregnant women with GDM may be associated with increased risk of preterm birth and neonatal respiratory complications, but not associated with adverse maternal outcomes, except preterm labor.