Editorial

Fain, James R.

doi:10.1177/014572179101700601

Cited by 2 publications

(1 citation statement)

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“…Gestational diabetes mellitus (GDM) occurs in 2–5% of all pregnancies and is known to be associated with poor maternal and fetal outcomes. [ 1 2 3 4 5 ] Apart from being implicated as a risk factor for future type 2 diabetes in the mother,[ 6 ] GDM also leads to several adverse fetal outcomes such as macrosomia, shoulder dystocia and other birth injuries, and neonatal hypoglycemia, in addition to congenital anomalies and stillbirths, all of which contribute to the increase in neonatal mortality and morbidity. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)

Mahalakshmi

Bhavadharini

Maheswari

et al. 2016

Indian J Endocr Metab

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Aim:To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC).Materials and Methods:Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records.Results:Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m2 vs. 25.2 ± 5.1 kg/m2; P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone.Conclusion:Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings.

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