Maternal and fetal outcomes of gestational diabetes in Bangladesh: a cohort analysis
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250845Keywords:
Gestational diabetes mellitus, Hyperglycemia, Maternal complications, Neonatal complicationsAbstract
Background: Gestational diabetes mellitus (GDM) is a significant public health concern, affecting a growing number of pregnancies worldwide. It is associated with increased risks of maternal and neonatal complications, impacting both short- and long-term health outcomes. This study explores the maternal and fetal outcomes of GDM in a Bangladeshi cohort.
Methods: This cohort study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January, 2018 to December, 2020to evaluate maternal and fetal outcomes in pregnant women with and without gestational diabetes mellitus (GDM) at a tertiary care hospital in Bangladesh. A total of 100 pregnant women participated, with 50 women in the GDM group and 50 women in the non-GDM group. The data were analyzed using SPSS version 26. A p value of less than 0.05 is considered statistically significant.
Results: This study highlights significant maternal and neonatal risks associated with gestational diabetes mellitus (GDM) in Bangladesh. Hypertensive disorders (56% vs. 20%), caesarean delivery (70% vs. 36%) and preterm labor (40% vs. 14%) were notably higher in the GDM group. Neonatal complications included increased preterm births (40% vs. 14%), low birth weight (20% vs. 6%), macrosomia (16% vs. 4%), NICU admissions (36% vs. 12%) and congenital heart defects (12% vs. 4%).
Conclusions: This study on gestational diabetes mellitus (GDM) in Bangladesh reveals significant maternal and fetal complications associated with the condition. GDM was linked to increased rates of hypertensive disorders, caesarean delivery and postpartum hemorrhage. Neonates of mothers with GDM experienced higher incidences of preterm birth, macrosomia, neonatal hypoglycemia and NICU admissions, indicating the substantial impact of GDM on perinatal outcomes.
Metrics
References
Association AD. Diagnosis and classification of diabetes mellitus. Diabetes care. 2014;37(1):81–90. DOI: https://doi.org/10.2337/dc14-S081
Kumar A, Gangwar R, Ahmad Zargar A, Kumar R, Sharma A. Prevalence of diabetes in India: A review of IDF diabetes atlas 10th edition. Current Diab Rev. 2024;20(1):105–14. DOI: https://doi.org/10.2174/1573399819666230413094200
Begum R, Roy S, Banik S. The prevalence of gestational diabetes mellitus in Bangladesh: a systematic review and meta-analysis. Int J Diabetes Dev Ctries. 2022;42(4):606–13. DOI: https://doi.org/10.1007/s13410-022-01091-2
Buchanan TA, Xiang AH. Gestational diabetes mellitus. The J Clin Invest. 2005;115(3):485–91. DOI: https://doi.org/10.1172/JCI24531
Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes care. 2007;30:141. DOI: https://doi.org/10.2337/dc07-s206
Jayawardena R, Sooriyaarachchi P, Misra A. Abdominal obesity and metabolic syndrome in South Asians: prevention and management. Expert Review of Endocrinol & Metabol. 2021;2;16(6):339–49. DOI: https://doi.org/10.1080/17446651.2021.1982381
Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes. N Engl J Med. 2009;361(14):1339–48. DOI: https://doi.org/10.1056/NEJMoa0902430
Khan R, Ali K, Khan Z. Maternal and fetal outcome of gestational diabetes mellitus. Gomal J Med Sci. 2013;11(1):451.
Daniela R. Fetal and neonatal complications of diabetic pregnancy. The Moldovan Medical Journal. 2017;60(4):50–6.
Riaz M, Askari S, Naseem R. Exploring maternal and neonatal outcomes in women with Type-1 Diabetes: A study from Pakistan. Pakistan J Med Sci. 2022;40(7):91-9. DOI: https://doi.org/10.12669/pjms.40.7.9199
Nasreen HE, Leppard M, Al Mamun M, Billah M, Mistry SK, Rahman M, et al. Men’s knowledge and awareness of maternal, neonatal and child health care in rural Bangladesh: a comparative cross-sectional study. Reprod Health. 2012;9(1):18. DOI: https://doi.org/10.1186/1742-4755-9-18
Immanuel J, Simmons D. Screening and Treatment for Early-Onset Gestational Diabetes Mellitus: a Systematic Review and Meta-analysis. Curr Diab Rep. 2017;17(11):115. DOI: https://doi.org/10.1007/s11892-017-0943-7
Care D. Standards of medical care in Diabetes 2019. Diabetes Care. 2019;42(1):124-38. DOI: https://doi.org/10.2337/dc19-S011
Kitzmiller JL, Ferrara A, Peng T, Cissell MA, Kim C. Preexisting diabetes and pregnancy. National Institute of Diabetes and Digestive and Kidney Diseases (US). 2018;5:33651557.
Carpenter MW. Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes care. 2007;30:56. DOI: https://doi.org/10.2337/dc07-s224
HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes: the HAPO study cooperative research group. Obstetrical & Gynecological Survey. 2008;63(10):615-6. DOI: https://doi.org/10.1097/OGX.0b013e318187b7a2
Lewandowska M. Maternal obesity and risk of low birth weight, fetal growth restriction and macrosomia: multiple analyses. Nutrients. 2021;13(4):1213. DOI: https://doi.org/10.3390/nu13041213
Hillier TA, Pedula KL, Vesco KK, Schmidt MM, Mullen JA, LeBlanc ES. Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. Obstetrics & Gynecology. 2008;112(5):1007-14. DOI: https://doi.org/10.1097/AOG.0b013e31818a9779
Sodje JD. Fetal Growth Abnormalities: Intrauterine Growth Restriction and Macrosomia. Contemporary Obstetrics and Gynecology for Developing Countries. 2021:103-15. DOI: https://doi.org/10.1007/978-3-030-75385-6_11
Voormolen DN, de Wit L, van Rijn BB, DeVries JH, Heringa MP, Franx A, et al. Neonatal hypoglycemia following diet-controlled and insulin-treated gestational diabetes mellitus. Diabetes Care. 2018;41(7):1385-90. DOI: https://doi.org/10.2337/dc18-0048
Murphy HR, Steel SA, Roland JM, Morris D, Ball V, Campbell PJ, et al. East Anglia Study Group for Improving Pregnancy Outcomes in Women with Diabetes (EASIPOD). Obstetric and perinatal outcomes in pregnancies complicated by Type 1 and Type 2 diabetes: influences of glycaemic control, obesity and social disadvantage. Diabetic Medicine. 2011;28(9):1060-7. DOI: https://doi.org/10.1111/j.1464-5491.2011.03333.x
Ornoy A, Reece EA, Pavlinkova G, Kappen C, Miller RK. Effect of maternal diabetes on the embryo, fetus and children: congenital anomalies, genetic and epigenetic changes and developmental outcomes. Birth Defects Research Part C: Embryo Today: Reviews. 2015;105(1):53-72. DOI: https://doi.org/10.1002/bdrc.21090
Downloads
Published
How to Cite
Issue
Section
