ĐÁNH GIÁ HIỆU QUẢ THÀNH CÔNG CỦA ĐIỀU TRỊ TIẾT CHẾ Ở THAI PHỤ ĐƯỢC CHẨN ĐOÁN ĐÁI THÁO ĐƯỜNG THAI KỲ TẠI BỆNH VIỆN HUYỆN BÌNH CHÁNH

Abstract

Background: Gestational diabetes (GDM) causes adverse effects on maternal and newborn health. An appropriate regime plays the most important role to control blood sugar during pregnancy. This study is aimed to evaluate the successful rate of implementing a detailed diet to women suffered from GDM in Binh Chanh hospital. Methods: A prospective longitudinal study was carried out from 01/11/2020 – 30/6/2021 at Binh Chanh District Hospital. There were 143 pregnant women diagnosed with GDM in the period from 24 weeks recruited in this study. They were applied a detailed regime in which the calorie intake is strictly calculated following to the Ministry of Health in Vietnam. All GDM women were followed up until their delivery and evaluate the maternal and fetal outcomes. A successful treatment is defined when the blood sugar at the target level. Results: The successful rate of implementing a detailed regime is 83,9% (CI 95%: 78,3 – 89,5). We established a daily regime with an appropriate increased calories that matches to two final trimesters of gestation : From 24 weeks to 28 weeks is 1685.5 ± 310.1 calories; from 29weeks to 32 weeks is1609,2 ± 316,6 calories; and from 33 weeks to 37 weeks is 1704,3 ± 327,6 calories. A treatment failure with blood sugar unmet the target is related to pregnant women who were not strictly followed the regime with a relative risk at  14,3 times (95% CI: 1,9 – 102,4; p=0,008). GDM women with treatment failure are significantly increased risks of  caesarean section and neonatal complications from17,8 times higher (95% CI: 1,3 – 247,4; p=0,032) to 4,3 times higher  (95% CI: 1,1 – 16,8; p=0,039), respectively. Conclusion: A detailed regime helps GDM women meet the target of blood sugar and reduce the maternal and fetal outcomes.