Study of maternal, fetal and neonatal outcomes in patients with gestational diabetes mellitus in a tertiary care hospital

Deepali S. Jadhav, Uma N. Wankhede


Background: GDM is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with gestational diabetes are characterized by a relatively diminished insulin secretion and pregnancy induced insulin resistance primarily present in the skeletal muscle tissue. Normal pregnancy is a diabetogenic state characterized by exaggerated rate and amount of insulin release, associated with decreased sensitivity to insulin at cellular levels. The objective of the study was to study the maternal, the fetal and the neonatal outcomes of treated patients of GDM in present study.

Methods: It was a hospital based clinical study. 1000 patients were enrolled between 24-28 weeks of gestation and DIPSI test was performed. Diagnosis of GDM was done using DIPSI criteria. 80 patients were diagnosed with GDM and followed till delivery to study the maternal, fetal and neonatal outcome.

Results: Elderly patients, patients with previous history of GDM, patients with family history of diabetes, patients with high BMI and patients with polyhydramnios are at high risk for GDM.

Conclusions: Hypertensive disorders and preterm birth are known to be higher with GDM are similar to the non-GDM group suggesting that early diagnosis and prompt treatment and maintaining strict glycemic control by patient may be beneficial. GDM can be managed well on MNT and lifestyle modifications, only few patients required insulin therapy. In spite of appropriate glycemic control, the incidence of macrosomia found to be high in GDM group. Sudden unexplained stillbirth can occur in spite of strict glycemic control. Neonatal complications have occurred despite well glycemic control.


DIPSI, GDM, MNT, Macrosomia, Stillbirth

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Braunwald, Kasper, Hauser, Longo, Jamesonet. Powers AC. Diabetes mellitus. Harrison principles of Internal Medicine 17th ed. New York: Mc Graw-Hill. 2005;2:2275.

Committee on Obstetric Practice. Committee opinion no. 504: screening and diagnosis of gestational diabetes mellitus. Obstet Gynecol. 2011;118(3):751-3.

O’Sullivan, Mahan CM. Criteria for oral glucose tolerance test in pregnancy. Diabetes. 1964;13:278.

Jovanovic L, Braun CB, Druzin ML and Patterson CM. The management of diabetes and pregnancy. Diabetes management. 1st ed. New York. 1982;28-65.

Fernando A, Daftary SN, Bhide AG. Diabees in pregnancy. In practical guide to high risk pregnancy and delivery.3rd edition. Noida: Saunders Elsevier. 2008;17:440.

Abha S. Screening of diabetes mellitus-Why? When? and How? Obstet Gynecol today. 2009;14:233-4

Seshiah V, Balaji V, Balaji MS, Sekar A, Sanjeevi CB, Green A. One step procedure for screening and diagnosis of gestational diabetes mellitus. Diabetes. 2005;126:200.

Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Prevalence of gestational diabetes mellitus in South India (Tamil Nadu) a community based study. J Assoc Physic Ind. 2008;1(56):329-3.

Nilofer AR, Raju VS, Dakshayini BR, Zaki SA. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes. Indian J Endocrinol Metab. 2012;16(11):74.

Das V, Kamra S, Mishra A, Agarwal A, Agarwal CG. Screening for gestational diabetes and maternal and fetal outcome. J Obstet Gynecol India. 2004;54:449-51.

Rajput M, Bairwa M, Rajput R. Prevalence of gestational diabetes mellitus in rural Haryana: A community-based study. Indian J Endocrinol Metabol. 2014;18(3):350.

Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. JAPI. 2004;21;52:707-11.

Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S. Gestational diabetes mellitus-guidelines. JAPI. 2006;1:54.

Bhat M, Ramesha KN, Sarma SP, Sangeetha Menon SC, Kumar G. Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in south India. Int J Diabet Developing Countries. 2010;30(2):91.

Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, Wakhloo A, Singh J. Prevalence of gestational diabetes mellitus (GDM) and its outcomes in Jammu region. J Assoc Physicians India. 2011;59(4):227-30.

Joy R, Sivakumar V. A Prospective Study on the Effect of Gestational Diabetes Mellitus on Maternal and Fetal Outcome. International Journal. 2012;3(3):345-51