Risk Factors for Poor Blood Sugar Control in Patients with Gestational Diabetes Mellitus

MA Huifeng; JIN Shanshan; XUE Lingling

doi:10.3969/j.issn.1004-437X.2025.02.018

Abstract：Objective To explore the risk factors of poor blood glucose control in patients with gestational diabetes mellitus(GDM)and the predictive value of serum obestatin,fructosamine(FRU)and neuregulin 4(NRG4).Methods The clinical data of 90 patients with GDM admitted to Henan University of Science and Technology First Affiliated Hospital New Area Hospital from January 2021 to June 2022 were retrospectively analyzed.According to whether the selected patients'prenatal fasting blood glucose(FBG)reached 3.3-5.3 mmol·L-1,they were divided into the good blood sugar control group(47 cases)and the poor blood sugar control group(43 cases).The clinical data of the two groups were compared,and the multivariate logistic regression analysis was used to analyze the risk factors for poor blood sugar control in GDM patients.The predictive value of serum obestatin,FRU,and NRG4 for poor blood glucose control in patients with GDM was analyzed by the receiver operating characteristic(ROC)curve.Results The results of multivariate logistic regression analysis showed that high pre-pregnancy BMI,low score of medication compliance,low score of dietary control,low level of serum obestatin,other pregnancy complications,high levels of serum FRU and high levels of serum NRG4 were independent risk factors for poor blood sugar control in patients with GDM(P＜0.05).The area under curve(AUC)for diagnosing poor blood glucose control in GDM patients with serum obestatin,FRU,NRG4,and combined examination were 0.656,0.630,0.706,and 0.848,respectively,with sensitivity of 67.44％,69.77％,65.12％,and 79.07％,and specificity of 68.09％,65.96％,68.09％,and 78.72％,respectively.The AUC,sensitivity,and specificity of combined examination were the highest(P＜0.05).Conclusion Older age,high pre-pregnancy BMI,low medication compliance scores,low dietary control scores,low level of serum obestatin,junior high school and below,other pregnancy complications high levels of serum FRU,and high levels serum NRG4 were risk factors for poor glycemic control in patients with GDM.The effectiveness of blood glucose control could be evaluated based on changes in levels of serum obestatin,FRU,and NRG4 in patients,the combined examination of the three had the highest predictive value,and targeted treatment and intervention measures could be formulated in clinic to improve the effect of blood sugar control.