Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India

Abstract

Background:Women with gestational diabetes mellitus (GDM) pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life.Objectives:The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies.Materials and Methods:This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies.Results:Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all). Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001) among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05) in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero.Conclusion:Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

Maternal and fetal outcome in gestational diabetes mellitus

“…6% babies were intrauterine deaths in the present study similar to 6% intrauterine deaths reported in the study by Saxena et al 10 The Indian consensus is that a new born weighing >3.5 kg should be considered as macrosomia. In present study, 40% babies were macrosomic at birth which is high compared to other Indian studies were the incidence was 28%.…”

“…According to Shefali et al, 1.4% babies had congenital anomalies, while according to Saxena et al, 10% babies had congenital anomalies. 4,10 In present study 37 patients followed up at 6 weeks with FBS and PLBS. Out of these, 16.2% patients were found to have diabetes on follow-up.…”

“…In the study be Saxena et al, the incidence of pre-eclampsia was 40%. 10 According to Xiong et al, mothers with GDM were at increased risk of presenting with pre-eclampsia. 11 Thus there is an association between pre-eclampsia and GDM and early diagnosis and initiation of treatment should be done to improve the outcome.…”

A pregnancy with GDM, hypothyroidism, polyhydrramnios with history of treatment for subfertility

“…The incidence of pregnancy-induced hypertension (PIH); hypothyroidism and polyhydramnios were also observed more in diabetic pregnancies. 13 Good glycemic control is mandatory and it can be done by diet, exercise with or without insulin. Ultrasonography of pregnancy profile, anomaly scan as well as foetal echocardiography plays a very important role in this type of high risk pregnancy.…”

Fetomaternal outcome in women with gestational diabetes mellitus

“…In this study, caesarian section rate was 74% which is higher compared to the findings of Jensen DM et al, Bener AB et al and Saxena P et al, who observed CS rate as 33%, 27.9%, 42% respectively. [16][17][18] The main indications for CS being previous caesarian, cephalopelvic disproportion, fetal distress, malpresentation and fetal macrosomic. The present study showed 9% of perinatal deaths in GDM compared to 1% deaths in control group.…”