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Capobianco G, Gulotta A, Tupponi G, Dessole F, Pola M, Virdis G, Petrillo M, Mais V, Olzai G, Antonucci R, Saderi L, Cherchi PL, Dessole S, Sotgiu G. Materno-Fetal and Neonatal Complications of Diabetes in Pregnancy: A Retrospective Study. J Clin Med 2020; 9:jcm9092707. [PMID: 32825775 PMCID: PMC7564828 DOI: 10.3390/jcm9092707] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
The aim of this case-control study was to evaluate maternal-fetal and neonatal clinical outcomes in a group of patients with gestational diabetes mellitus (GDM) and pregestational diabetes such as diabetes mellitus type 1 (DM1) and diabetes mellitus type 2 (DM2) and compare them with those of patients without diabetes. A total of 414 pregnant women, nulliparous and multiparous, with single pregnancy were recruited. The selected patients were divided into two groups. Among 207 patients (group cases), 183 had GDM and 24 pregestational diabetes (of which n = 17 diagnosed with DM1 and n = 7 with diagnosis of DM2). Two-hundred-seven patients with a negative pathologic history of GDM, DM1 and DM2 represented the population of controls (group control). We reported an incidence of preterm delivery of 23.2% in the group of cases, of 18.3% in the group of patients with GDM and 66.7% in the group of patients DM1/2. Fetal growth disorders, such as intrauterine growth retardation (IUGR), small for gestational age (SGA), fetal macrosomia, were detected in four fetuses out of 207 (1.93%) in the control group and 20 fetuses out of 207 in the case group (9.67%, p-value 0.001); of these 16 of 183 fetuses of the GDM group (8.74%, p-value 0.002) and 4 of 24 fetuses of the DM1/2 group (16.67%, p-value 0.005). A very strong correlation between diabetes mellitus type 1 and preeclampsia (p-value < 0.0001) was observed. Close monitoring of pregnant women with diabetes is recommended to prevent maternal-fetal and neonatal complications.
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Affiliation(s)
- Giampiero Capobianco
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
- Correspondence: ; Tel.: +39-3392-897-821; Fax: +39-079-228-265
| | - Alessandra Gulotta
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Giulio Tupponi
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Francesco Dessole
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Maddalena Pola
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Giuseppe Virdis
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Marco Petrillo
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Valerio Mais
- Gynecologic and Obstetric Clinic, University of Cagliari, 09121 Cagliari, Italy;
| | - Giorgio Olzai
- Neonatal Intensive Care Unit (NICU), Sassari University, 07100 Sassari, Italy;
| | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (L.S.); (G.S.)
| | - Pier Luigi Cherchi
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Salvatore Dessole
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.G.); (G.T.); (F.D.); (M.P.); (G.V.); (M.P.); (P.L.C.); (S.D.)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (L.S.); (G.S.)
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Grandi G, Del Savio MC, Caroli M, Capobianco G, Dessole F, Tupponi G, Petrillo M, Succu C, Paoletti AM, Facchinetti F. The impact of COVID-19 lockdown on admission to gynecological emergency departments: Results from a multicenter Italian study. Int J Gynaecol Obstet 2020; 151:39-42. [PMID: 32602939 PMCID: PMC9087600 DOI: 10.1002/ijgo.13289] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 12/01/2022]
Abstract
Objective To evaluate the impact of the COVID‐19 lockdown on admissions to gynecological emergency departments (ED) of three Italian university hospitals with different rates of COVID‐19 incidence. Methods A retrospective study was conducted in the gynecological EDs of Modena (Emilia‐Romagna), Sassari and Cagliari (Sardinia) regarding all admissions to gynecological EDs during November 1 to 30, 2019, and March 11 to April 9, 2020 (lockdown period). Results A total of 691 women (mean age 38.3 ± 14.3 years) who were admitted to the gynecological EDs were included. The relative decrease in women evaluated from March 11 to April 9, 2020, was −56.6% (95% confidence interval [CI] 52.2–61.1). Time spent in the ED was also significantly shorter during this period (P=0.02) in comparison to November 1 to 30, 2019. The most evident decrease was observed for pelvic pain (−68.9% [95% CI 60.3–76.7]; −91 cases). The management of women suggests a more effective use of the ED, with higher rates of hospitalization (P=0.001) and recourse to emergent surgeries (P=0.005) and lower rates of discharge to home (P=0.03). Conclusion The COVID‐19 lockdown greatly reduced the rate of admission to gynecological EDs, but the real emergencies were filtered from the more deferrable ones. The COVID‐19 lockdown greatly reduced the admission rate to gynecological emergency departments, particularly for pelvic pain; however, real emergencies were filtered from more deferrable cases.
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Affiliation(s)
- Giovanni Grandi
- Department of Medical and Surgical Sciences for Mother, Child and Adult, Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria C Del Savio
- Department of Medical and Surgical Sciences for Mother, Child and Adult, Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Caroli
- Department of Medical and Surgical Sciences for Mother, Child and Adult, Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Giampiero Capobianco
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Francesco Dessole
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giulio Tupponi
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Marco Petrillo
- Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Claudia Succu
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), University of Cagliari, Cagliari, Italy
| | - Anna M Paoletti
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), University of Cagliari, Cagliari, Italy
| | - Fabio Facchinetti
- Department of Medical and Surgical Sciences for Mother, Child and Adult, Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
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