Fetomaternal outcome in gestational diabetes mellitus: a retrospective study

Koluguri Bhavana; Sheela S. R.; Nandini S.; Divya J. Patil

doi:10.18203/2320-1770.ijrcog20251244

Authors

Koluguri Bhavana Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Karnataka, India
Sheela S. R. Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Karnataka, India
Nandini S. Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Karnataka, India
Divya J. Patil Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251244

Keywords:

GDM, LSCS, Neonatal outcomes, Maternal complications, Retrospective study

Abstract

Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication that can adversely affect both maternal and neonatal outcomes. This study aimed to retrospectively evaluate fetomaternal outcomes in GDM by comparing lower segment caesarean section (LSCS) and normal vaginal delivery groups.

Methods: A retrospective review of medical records from January 2018 to December 2020 was conducted at a tertiary care hospital. Fifty-one patients with GDM were included, with 29 undergoing LSCS and 22 having normal vaginal deliveries. Demographic, maternal, neonatal, lifestyle, and postpartum parameters were extracted and statistically analyzed using t-tests and Chi-square tests, with a significance threshold of p<0.05.

Results: No significant differences were observed in maternal age, height, weight, body mass index (BMI), or gestational age at diagnosis between groups. However, birth weight values showed significant variation (p=0.039), though data discrepancies were noted. Maternal complications were significantly higher in the LSCS group (p=0.024), particularly due to previous caesarean sections and complex comorbidities. Neonatal outcomes also differed, with the LSCS group requiring more specialized care (IDM care, NICU admissions) and showing lower Apgar scores (p=0.015). Lifestyle factors and postpartum recovery were comparable between groups.

Conclusions: The study highlighted that while baseline maternal characteristics were similar, significant differences in maternal complications and neonatal outcomes exist between LSCS and vaginal deliveries in GDM pregnancies. These findings underscore the need for individualized management and vigilant monitoring to optimize both maternal and neonatal health.

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References

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):S81-90. DOI: https://doi.org/10.2337/dc14-S081

Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007;30(2):S141-6. DOI: https://doi.org/10.2337/dc07-s206

Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest. 2005;115(3):485-91. DOI: https://doi.org/10.1172/JCI24531

Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002;25(10):1862-8. DOI: https://doi.org/10.2337/diacare.25.10.1862

HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991-2002. DOI: https://doi.org/10.1056/NEJMoa0707943

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):e49-64. DOI: https://doi.org/10.1097/AOG.0000000000002501

Nicholson WE, Mulla MJ, Tchou P-J. Management of gestational diabetes mellitus. BMJ. 2017;358:j3296.

Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med. 2008;358(19):2003-15. DOI: https://doi.org/10.1056/NEJMoa0707193

Kim SY, England JL, Sharma S. Risk of adverse pregnancy outcomes in women with gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2010;203(3):e1-7.

Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352(24):2477-86. DOI: https://doi.org/10.1056/NEJMoa042973

Hawdon JM, Harding JE, Thomas M, Raynor B. Neonatal hypoglycemia: incidence and short-term consequences. Arch Dis Child Fetal Neonatal Ed. 1990;65(5):508-10.

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

England LJ, Levine RJ, Klebanoff MA. Cigarette smoking during pregnancy and preterm birth. Obstet Gynecol. 1990;75(4):525-30.

HAPO Study Cooperative Research Group; Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. Diabetes Care. 2008;31(2):340-6.

Bonomo M, Campagna A, Mancuso E. Long-term follow-up of gestational diabetes mellitus: a review. Diabetes Metab Res Rev. 2012;28(1):23-30.

Fareed P, Siraj F, Lone K. Fetomaternal outcome in women with gestational diabetes mellitus. Int J Res Med Sci. 2017;5(9):4151. DOI: https://doi.org/10.18203/2320-6012.ijrms20174001

Nayak PK, Mitra S, Sahoo JP, Daniel M, Mathew A, Padma A. Feto-maternal outcomes in women with and without gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Diabetes Metab Syndr. 2013;7(4):206-9. DOI: https://doi.org/10.1016/j.dsx.2013.10.017

Jani SK, Parikh PM, Patel KM, Shah AC, Patel BS, Rangrej RB. Fetomaternal outcome in patients with gestational diabetes mellitus. Nat J Physiol Pharm Pharmacol. 2023;13(3):652-6. DOI: https://doi.org/10.5455/njppp.2023.13.01032202306022023

Patel TL, Jadav KD. A study of feto-maternal outcome in cases of gestational diabetes mellitus. Int J Reprod Contracept Obstet Gynecol. 2023;12(2):377-82. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230039