Prospective study of maternal outcomes in primigravida with gestational diabetes mellitus in a tertiary care centre Venjaramood, Thiruvananthapuram
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20215075Keywords:
Gestational diabetes mellitus, 75 g OGTT, Medical nutrition therapy, InsulinAbstract
Background: The prevalence of Gestational diabetes mellitus (GDM) is on the rise. Understanding the various outcomes of it is essential to face this challenge. The aim of the study was to understand the maternal outcomes of GDM in primigravida and to compare the maternal outcomes in primigravida with GDM and without GDM.
Methods: This prospective study was conducted in the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, on 180 primigravida mothers,90 with and 90 without gestational diabetes. GDM was diagnosed with IADPSG criteria using 75 g Oral glucose tolerance test (OGTT).
Results: A total of 180 primigravida with singleton gestation, 90 with GDM and 90 without GDM were followed from pregnancy to delivery after fulfilling criteria during study period. 65.6% GDM mothers had good compliance with Medical nutrition therapy (MNT) and exercise. 88.8% of GDM mothers required induction of labour, 13.3% had pregnancy induced hypertension, 12.2% had vulvovaginal candidiasis and 10% had postpartum hemorrhage. Thus, women with GDM on MNT or MNT with insulin had a higher risk of adverse maternal outcomes but was comparable to normoglycemic mothers if they had good compliance to MNT or insulin.
Conclusions: Women with GDM had a higher but comparable risk of adverse maternal outcomes as compared to normoglycemic pregnant mothers, if they strictly adhere to MNT with or without insulin reflecting the importance of good treatment compliance.
References
Calkins K, Devaskar SU. Fetal origins of adult disease. Curr Probl Pediatr Adolescent Health Care. 2011;41(6):158-76.
Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707-11.
Svare JA, Hansen BB, Mølsted-Pedersen L. Perinatal complications in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand. 2001;80(10):899-904.
Weindling A. Offspring of diabetic pregnancy: short-term outcomes. Seminars Fetal Neonatal Med. 2009;14(2):111-8.
Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Gestational diabetes mellitus manifests in all trimesters of pregnancy. Diabetes Res Clin Pract. 2007;77(3):482-4.
Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Kapur A. Pregnancy and diabetes scenario around the world: India. Int J Gynaecol Obstet. 2009;104:35-8.
Bano S, Agrawal A, Asnani M, Das V, Singh R, Pandey A, et al. Correlation of Insulin Resistance in Pregnancy with Obstetric Outcome. J Obstet Gynaecol India. 2021;71(5):495-500.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.
NICE. Diabetes in Pregnancy: Management from Preconception to Post natal period NICE Guideline, 2015. Available at: www.nice.org.uk/guidance/ng3. Accessed on 01 December 2021.
Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Kapur A. Pregnancy and diabetes scenario around the world: India. Int J Gynaecol Obstet. 2009;104:35-8.
Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773-9.
Retnakaran R, Qi Y, Connelly PW, Sermer M, Zinman B, Hanley AJ. Glucose intolerance in pregnancy and postpartum risk of metabolic syndrome in young women. J Clin Endocrinol Metab. 2010;95(2):670-7.
Turok DK, Ratcliffe SD, Baxley EG. Management of gestational diabetes mellitus. Am Fam Physician. 2003;68(9):1767-72.
Mahalakshmi MM, Bhavadharini B, Maheswari K, Kalaiyarasi G, Anjana RM, Ranjit U, et al. Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3). Indian J Endocrinol Metab. 2016;20(4):491-6.
Shou C, Wei M, Wang C, Yang H. Updates in Long-term Maternal and Fetal Adverse Effects of Gestational Diabetes Mellitus. Maternal-Fetal Med. 2019;1(2):91-4.
Bhat M, Ramesha KN, Sarma SP, Menon S, Ganesh KS. Outcome of gestational diabetes mellitus from a tertiary referral center in South India: a case-control study. J Obstet Gynaecol India. 2012;62(6):644-9.
Peterson L, Peterson CM. Nutritional management of the obese gestational diabetic pregnant woman. J Am Coll Nutr. 1992;11(3):246-50.
Ghosh S, Ghosh K. Maternal and neonatal outcomes in gestational diabetes mellitus. J Indian Med Assoc. 2013;111(5):330-1.
Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, Wakhloo A, et al. Prevalence of gestational diabetes mellitus (GDM) and its outcomes in Jammu region. J Assoc Physicians India. 2011;59:227-30.
Hamza A, Herr D, Solomayer EF, Solomayer G. Polyhydramnios: Causes, Diagnosis and Therapy. Geburtshilfe Frauenheilkd. 2013;73(12):1241-6.
Goldman M, Kitzmiller JL, Abrams B, Cowan RM, Laros RK. Obstetric complications with GDM. Effects of maternal weight. Diabetes. 1991;40(2):79-82.