A prospective study of diabetes in pregnancy and its impact on pregnancy outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231206Keywords:
Overt diabetes, Gestational diabetes mellitus, Macrosomia, Polyhydramnios, Hyperbilirubinemia, Respiratory distressAbstract
Background: Diabetes complicating pregnancy has become common worldwide. However due to advances in the management of diabetes and its complications, there has been an overall improvement in the maternal and perinatal outcome. Diabetes occurs quite often during pregnancy even in unsuspected cases which can be either pregestational diabetes mellitus or gestational diabetes mellitus. Our objective was to study the impact of diabetes on pregnancy outcome.
Methods: A prospective observational study was conducted at department of obstetrics and gynaecology of a tertiary care centre over a period of 18 months (January 2019 to June 2020). All patients were subjected to detailed history and clinical examination followed by relevant investigations such as complete blood count, blood sugars, HbA1C, renal function test, liver function test, urine albumin/sugar/ketones including ultrasonography obstetrics, congenital anomaly scan and doppler study of uterine and umbilical artery. All the data was compiled in Microsoft excel-sheet and was subjected to appropriate statistical tests.
Results: Incidence of diabetes was found to be 9.72 % in our study population which included gestational diabetes mellitus (77/107) as well as overt diabetes (30). Diabetes was found to be more common in overweight and obese patients (75.7%). Macrosomia (19.6%) followed by polyhydramnios (15.6%) was the most common complication seen in pregnancy complicated by diabetes. Most common neonatal complication seen was hyperbilirubinemia 19(17.75%) and respiratory distress 18 (16.82%) in babies born to diabetic mother.
Conclusions: Pregnant women with diabetes have more maternal, fetal, and neonatal complications, with overt diabetic group being more prone to complications.
References
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.
Metzger BE, Gabbe SG, Persson B. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diab Care. 2010;33(3): 676-82.
Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The international federation of gynecology and obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynecol Obstet. 2015;131:S173-211.
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 Region. J Assoc Physic India. 2011;59:227-30.
Klara P, Kachhwaha CP, Singh HV. Prevalence of gestational diabetes mellitus and its outcome in western Rajasthan. Indian J Endocrinol Metab. 2013; 17(4),677-80.
Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Womens Health. 2011;3:367-73.
Capula C, Chiefari E, Vero A, Arcidiacono B, Iiritano S, Puccio L, et al. Gestational diabetes mellitus: screening and outcomes in southern italian pregnant women. Endocrinol. 2013;5:387495.
