Comparative study of fetal outcomes in pregestational and gestational diabetes mellitus

Authors

  • Sara Guleria Department of Obstetrics and Gynecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Anoop Sharma Department of Obstetrics and Gynecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Kushla Pathania Department of Obstetrics and Gynecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232947

Keywords:

Foetal, Diabetes mellitus, High risk obstetrics

Abstract

Background: Diabetes mellitus is an emerging health problem worldwide and is now seen in increased frequency during pregnancy. Pregestational DM and GDM have an impact on the fetal outcome in terms of the baby weight, hypoglycemia, hyperbilirubinemia, respiratory distress syndrome and other complications in the fetus. This study was designed to study these effects in a comparative way between these two groups so as to equip ourselves better and provide better materno-fetal care.

Method: This was a prospective observational study conducted during a period of one year.All pregnant females attending the antenatal OPD were screened for diabetes mellitus. Those fulfilling the ADA criteria belonged to the pregestational diabetes mellitus group and those fulfilling the DIPSI criteria belonged to the GDM group. A proforma containing general information on demographic characteristics and neonatal outcome in terms of the baby status, baby weight, l, hypoglycaemia, hyperbilirubinemia, and respiratory distress syndrome was maintained. The whole data collected was then analyzed.

Results: The fetal outcome for Group DM was more adverse in comparison to the Group GDM. There was an increased incidence of macrosomia (27.9% vs. 8.25%), hyperbilirubinemia (87.1% vs. 53.1%), hypoglycemia and fetal wastage.

Conclusions: Pregnancy complicated with diabetes mellitus is a high risk pregnancy and the type of diabetes plays a crucial role in the fetal outcome of that pregnancy. An understanding of this can help provide better perinatal care and outcome.

References

What is Diabetes? Available at: https://www.idf.org/ aboutdiabetes/what-is-diabetes.html. Accessed on 20 February 2023.

Williams JW, Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams obstetrics. 25th ed. New York: McGraw - Hill Education; 2018:1107.

Cohen WR, Cherry SH, Merkatz IR. Cherry and Merkatz's Complications of pregnancy. USA: Williams & Wilkins; 2000:413.

Poulakos P, Mintziori G, Tsirou E, Taousani E, Savvaki D, Harizopoulou V, et al. Comments on gestational diabetes mellitus: from pathophysiology to clinical practice. Hormones. 2015;14(3):335-44.

Moore LE. Diabetes in pregnancy: the complete guide to management. USA: Springer; 2017:18;2-15.

Seshiah V, Balaji V, Balaji MS, Sekar A, Sanjeevi C, Green A. One step procedure for screening and diagnosis of gestational diabetes mellitus. J Obstet Gynecol India. 2005;126:200.

O’sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;13:278-85.

What is Diabetes?. Available at: http://www.idf.org/ node/23928. Accessed on 20 February 2023.

Maraschin JF. Classification of diabetes. Adv Exp Med Biol. 2011;771:12-9.

Carolan M, Davey MA, Biro MA, Kealy M. Maternal age, ethnicity and gestational diabetes mellitus. Midwifery. 2012;28(6):778-83.

Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA. Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta-analysis. BMC Preg Childbirth. 2010;10(1):1-4.

Mustary F, Chowdhury TA, Begum F, Mahjabeen N. Maternal and Perinatal Outcome in Gestational Diabetes Mellitus Compared to Pregestational Diabetes Mellitus. Birdem Med J. 2019;9(2):127-32.

Pal A, Dhiman B, Mittal R, Paul BJ. Prevalence of gestational diabetes mellitus and its feto-maternal outcome in Kamla Nehru state hospital for mother and child, IGMC, Shimla, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(11):4662-7.

Naher N, Chowdhury T, Begum R. Maternal and Fetal Outcome in Patients with Pregestational Diabetes Mellitus and Gestational Diabetes Mellitus and Their Comparison with Non-diabetic Pregnancy. Birdem Med J. 2015;5(1):9-13.

Downloads

Published

2023-09-28

Issue

Section

Original Research Articles