Enhanced recovery after surgery in elective cesarean section patients with gestational diabetes mellitus does not lead to glucose-related maternal and neonatal complications

作者：Jin Zhou, Peizhen Zhang, Zhangmin Tan, Chuo Li, Lin Yao, Tiantian He, Hongyin Hou, Yuzhu Yin · 发表于：Frontiers in Endocrinology · 年份：2024 · DOI：10.3389/fendo.2024.1403754 · 被引用次数：10 · 研究领域：Enhanced Recovery After Surgery、Gestational Diabetes Research and Management、Bariatric Surgery and Outcomes

Objective: For elective cesarean section patients with gestational diabetes mellitus (GDM), there is a lack of evidence-based research on the use of enhanced recovery after surgery (ERAS). This study aims to compare the ERAS after-surgery protocol and traditional perioperative management. Research design and methods: In this retrospective cohort study, singleton pregnancies with good glucose control GDM, delivered by elective cesarean sections under intravertebral anesthesia at least 37 weeks from January 1 to December 31, 2022, were collected at the Third Affiliated Hospital of Sun Yat-sen University. We divided all enrolled pregnant women and newborns into an ERAS group and a control group (the traditional perioperative management group) based on their adherence to the ERAS protocol. The primary outcome was the preoperative blood glucose level, with an increase of more than 1 mmol/L indicating clinical significance when compared to the control group. The secondary outcome was centered around an adverse composite outcome that affected both mothers and newborns. Results: <0.001), the primary outcome revealed that the mean glycemic difference between the groups was 0.47 mmol/L (95% CI 0.15-0.80 mmol/L), which was below the clinically significant difference of 1 mmol/L. For the secondary outcomes, the ERAS group had an 86% lower risk of a composite adverse outcome compared to the control group. This included a 73% lower risk of perioperative maternal hypoglycemia and a 92% lowe...