Risk factor for gestational diabetes mellitus and impact of gestational diabetes mellitus on maternal and fetal health during the antenatal period


  • Uma Jain Department of Obstetrics and Gynacology, GMC Associated with DHS, Shivpuri, Madhya Pradesh, India
  • Kusumlata Singhal Department of FICMCH Laparoscopy, Koteshwar Hospital, Gwalior, Madhya Pradesh, India
  • Shikha Jain Department of Obstetrics and Gynacology, GMC, Shivpuri, Madhya Pradesh, India
  • Deepali Jain GMC, Shivpuri, Madhya Pradesh, India




GDM, Polyhydramnios, Macrosomia, Congenital malformation


Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy.

 The adverse effects of GDM on pregnant women are pre-eclampsia, PIH, PPH, polyhydramanios, PROM, meanwhile, there would be an increase in dystocia, birth injury, and cesarean section

Methods: This retrospective study was conducted in a Gynecology clinic in District Shivpuri to find out the various risk factors for GDM and to evaluate the impact of GDM on maternal and fetal health during the antenatal period. 84 patients who were diagnosed with GDM were included in the study.

Results: Among risk factors; BMI >25 kg/m2 before pregnancy was found in 15.47% of the case, family history of diabetes mellitus 8.33%, Previous history of macrosomia 17.85%, Poor reproductive history 17.85%, baby with congenital malformation 8.33%, H/o unexplained IUFD 11.90%. H/o polyhydramnios 15.47%. History of PCOS 13.09% and preeclampsia was found in 17.85% of cases. In antenatal complications; miscarriages was found in 15.47%. polyhydramnios in 17.85%. Oligohydramnios in 8.33%, preterm labor in 11.90%, PROM in 9.52%, pre-eclampsia in 17.85%, sudden IUFD in 8.33% and congenital malformation was found in 4.76% of cases. On USG; IUGR was found in 7.14% of cases. Large for date fetus in 16.66% of cases and the normal growth was found in 76.19% of cases.

Conclusions- In conclusion appropriate and timely diagnosis and treatment of GDM will result in decreased maternal and neonatal adverse outcomes comparable to general population rates, therefore, early diagnosis is important.

Author Biographies

Uma Jain, Department of Obstetrics and Gynacology, GMC Associated with DHS, Shivpuri, Madhya Pradesh, India

Obstetric & Gynecology

Designated Professor, GMC Shivpuri.

Kusumlata Singhal, Department of FICMCH Laparoscopy, Koteshwar Hospital, Gwalior, Madhya Pradesh, India

MS, FICMCH Laparoscopic surgeon Director Koteshwar Hospital, Gwalior M.P. India

Shikha Jain, Department of Obstetrics and Gynacology, GMC, Shivpuri, Madhya Pradesh, India

M.B.B.S., M.S., FMAS, DMAS Consultant in Link Hospital, Ex Consultant in Gmers Medical College Gandhinagar (GUJARAT)

Deepali Jain, GMC, Shivpuri, Madhya Pradesh, India

Senior Resident, Department of  Obstetrics & Gynaecology, GMC Shivpuri  M.P. India.


Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991-2002.

Queenan JT, Catherine Y, Spong CJ. Protocols for high-risk pregnancies an evidence-based-approach. In: Diabetes mellitus. 7th ed. USA: Saunders; 2010:219-29.

Virkud A. Modern obstetrics. In: Diabetes during pregnancy 3rd ed. USA: Saunders;2009:151-60.

American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2011;34(1): S11-61.

Management of Diabetes in pregnanacy. Available at: http://www.diabetescourses.in/DMDEA-%20PROS-PECTUS/GDM/GDM_7/CCGDM_cycle_VII.pdf. Accessed on 20 May 2021.

Shirish ND, Shyam VD. Obstetrics and Genaecology for postgraduates and practitioners. In: Diabetes complicating pregnancy. 1st ed. USA: Saunders; 2005:14-27.

Hurt JK, Matthew WG, Jessica LB, Harold E. The Johns Hopkins manual of gynecology and obstetrics. In: Endocrine Disorders of Pregnancy. 4th ed. USA: Johns Hopkins publishers; 2013:164-85.

Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, et al. Prevalence of gestational diabetes mellitus (GDM) and its outcomes in Jammu. J Assoc Physician. 2011;59:227-30.

Dudhwadkar AR, Michelle NF. Maternal and fetal outcome in gestational diabetes mellitus. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3317-21.

Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC. 2018;18(1):494.

Usta A, Usta CS, Yildiz A, Ozcaglayan R, Dalkiran ES, Savkli A, Taskiran M. Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus. Pan Afr Med J. 2017;26:62.

Lavery J, Friedman A, Keyes K, Wright J, Ananth C. Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG Int J Obstet Gynaecol. 2017; 124(5):804-13.

Laine MK, Kautiainen H, Gissler M, Raina M, Aahos I, Jarvinen K, et al. Gestational diabetes in primiparous women- the impact of age and adiposity: a register-based cohort study. Acto Obstet Gynecol Scand. 2018;97(2):187-94.

Bunthalarath S, Sunsaneevithayakul P, Boriboo hirunsarn D. Risk factors for early diagnosis of gestational diabetes mellitus; Journal of the medical association of Thailand. Acto Obstet Gynecol Scand. 2004;87(3):s50-3.

Sorbye LM, Skjaeven R, Klugsoyi K, MOrgen NH. Gestational diabetes mellitus and interpregnancy weight change; A population-based cohort study. PLoS Med. 2017;14:e1002367.

Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of gestational diabetes; A systematic review of the literature with meta-analysis. Obes Rev. 2009; 10:194-203.

Riskin MS, Damien A, Younes G, Auslender R. First-trimester fasting hyperglycemia as a predictor for the development of gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol. 2010;152:163-7.

Retnakaran R, Connelly PW, Somers M, Zinman B, Hanley AJG. The impact of family history of diabetes on risk factors for gestational diabetes. Clin Endocrinol. 2007;67:754-60.

Ares J, Martin-Nieto A, Diaz-Naya L, Turton T, Menendez-Prada T, Ragnarsson CS, et al. Gestational diabetes mellitus (GDM): Relationship between higher cutoff values for 100 g oral glucose tolerance test (OGTT) and insulin requirement during pregnancy. Matern Child Health J. 2017;21:1488-92.

Nanda S, Savvidou M, Syngelaki A, Akolekar R, Kypros H. Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 week. Prenat Diagn. 2011;10:1002.

Zhuang W, Jia Lv, Liang Q, Chen W, Zhang S, Sun X. Adverse effects of gestational diabetes-related risk factors on pregnancy outcomes and intervention measures In: Experimental and Therapeutic Medicine. Germany: Spandidos Publications;2005.

Jindal A, Ahmed F, Bhardwaj B. Prevalence, clinical profile, and outcome of gestational diabetes mellitus. J Obstet Gynaecol India. 51:46; 2001.

Bhat M, Sarma SP, Menon S. Determinants of gestational diabetes mellitus: a case-control study in a district tertiary care hospital in south India. Int J Diabetes Dev Ctries. 2010;30(2):91-6.

Saxena P, Tyagi S, Prakash A, Nigam A.; Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of north India. Indian J Community Med. 2011;36(2):120-3.

Xiong X, Saunders LD, Wang FL, Demianczuk NN. Gestational diabetes mellitus; prevalence, risk factors, maternal and infant outcomes. Int J Gynaecol Obstet. 2001;75:221-8.

Buchanan TA, Xiang AH, Peters RK. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. Diabetes. 2002;51:2796-803.

Summit FA, Das A, Sarker S, Das J. Evaluating the effects of gestational diabetes mellitus on fetal birth weight. Dhaka University J Biol Sci. 2020;29(2):209-18.






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