Prediktivna vrednost metaboličkog sindroma u proceni toka i ishoda trudnoće

Abstract

Uvod: Termin metabolički sindrom (MS), sindrom insulinske rezistencije i sindrom X, koristi se za precizno definisanje udruženih abnormalnosti koje su povezane sa povećanim rizikom za razvoj dijabetes melitusa tipa 2 i aterosklerotskih kardiovaskularnih bolesti. Uniformna definicija MS ne postoji. Ciljevi rada: Utvrđivanje učestalosti MS u ispitivanom uzorku; ispitivanje povezanosti između osnovnih socio - demografskih karakteristika trudnica i MS; prisustva specifičnih navika trudnica i MS; ispitivanje pojedinih komponenti MS u trudnoći; ispitivanje prognostičkog značaja metaboličkog sindroma u proceni toka i ishoda trudnoće. Materijal i metode: Prospektivna, kohornta studija je obuhvatila 135 trudnica, hospitalizovanih u periodu 2013. i 2014. godine. Korišćena je medicinska dokumentacija Klinike za ginekologiju i akušerstvo, Kliničkog centra Srbije, kao i posebno, formiran strukturalni upitnik. Za analizu rezultata korišćene su deskriptivne i analitičke statisitičke metode. Rezultati: Učestalost MS u populaciji trudnica bila je 31,1%. Nakon kontrole na poznati konfaunding faktor uzrast, registrovano je da su trudnice sa MS imale 1,685 puta veću šansu za da im se porođaj završi carskim rezom (OR=1,685, p=0,048), da je MS bio statistički značajan prognostički faktor ranijih nedelja gestacije na porođaju (p=0,001), te da je MS bio statistički značajan prognostički faktor niže vrednosti Apgar skora novorođenčadi (p=0,003). Zaključak: Rana detekcija MS tokom trudnoće smanjuje perinatalni morbiditet i značajan je činilac kako toka tako i ishoda trudnoće.

Introduction: The term metabolic syndrome (MS), syndrome of insulin resistance and syndrome X has been used to precisely define the associated abnormalities which are associated with an increased risk for the development of type 2 diabetes mellitus, as well as atherosclerotic cardiovascular disease. The uniform definition of the MS does not exist. Objectives: Determining the incidence of MS in the tested sample; testing connectivity between the main socio - demographic characteristics of pregnant women and MS; the presence of specific habits of pregnant women and MS; testing of individual components of MS in pregnancy; the prognostic significance of the metabolic syndrome in assessing the course and outcome of pregnancy. Material and methods: Prospective cohort study included 135 pregnant women hospitalized in the period 2013 and 2014 year. Medical documentation of the Clinics for Gynecology and Obstetrics, Clinical center Serbia was used, as well the structural question - mark for pregnant women. Data analysis included descriptive and analytical methods. Results: The incidence of MS in the population of pregnant women was 31,1%. After controlling for the known confounding factor of age, we confirmed that women with MS had 1,685 times more likely to finish their birth by caesarean section (OR = 1.685, p = 0.048); that the MS was statistically significant prognostic factor in the earlier weeks of delivery (p = 0.001); also that the MS was statistically significant prognostic factor of lower Apgar scores in newborns (p = 0.003). Conclusion: The early detection of MS during pregnancy reduces perinatal morbidity and is an important factor for the pregnancy outcome.