A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

Authors

  • Manisha R. Gandhewar Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri, Mumbai, Maharashtra, India
  • Binti R. Bhatiyani Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri, Mumbai, Maharashtra, India
  • Priyanka Singh Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri, Mumbai, Maharashtra, India
  • Pradip R. Gaikwad Department of Obstetrics and Gynecology, ESIPGIMSR, Andheri, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20174054

Keywords:

DIPSI, Gestational Diabetes, Macrosomia, Shoulder dystocia

Abstract

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.

Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.

Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.

Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

References

Cunningham F Gary, Leveno Kenneth J, Bloom Steven L, Hauth John C, Rouse Dwight J, Spong Catherine Y. Diabetes. In, Williams Obstetrics, 24th edition. New York, Mc Graw Hill Medical Publisher;2014:1125-46.

Magon N. Gestational diabetes mellitus: Get, set, go from diabetes capital of the world to diabetes care capital of the world. Indian J Endocrinol Metab. 2011;15:161-9.

Dornhost A, Paterson CM, Nicholls JS. High prevalence of GDM in women from ethnic minority groups. Diabetic Med. 1992;9:820-2.

Odar E, Wandabwa J, Kiondo P. Maternal and fetal outcome of gestational diabetes mellitus in Mulago Hospital, Uganda. Afr Health Sci. 2004;4(1):9-14.

Agrawal S, Gupta AN. Gestational Diabetes. J Assoc Physicians India. 1982;30:203-5.

Narendra J, Munichoodappa C, Gurudas A, Ramprasad AV, Madhav T, Vijayalakshmi et al. Prevalence of glucose intolerance during pregnancy. Int J Diab Dev Countries. 1991;11:2-4.

Hedderson MM, Ferrara A, Sacks DA. Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. Obstet Gynecol. 2003;102(4):850-6.

Wood SL, Jick H, Sauve R. The risk of stillbirth in pregnancies before and after the onset of diabetes. Diabet Med. 2003;20(9):703-7.

Verheijen EC, Critchley JA, Whitelaw DC, Tuffnell DJ. Outcomes of pregnancies in women with pre-existing type 1 or type 2 diabetes, in an ethnically mixed population. BJOG. 2005;112(11):1500-3.

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 Physicians India. 2011;59:227-30.

Kalyani KR, Jajoo S, Hariharan C, Samal S. Prevalence of gestational diabetes mellitus, its associated risk factors and pregnancy outcomes at a rural setup in central India. Int J Reprod Contracept Obstet Gynecol. 2014;3:219-4.

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(Suppl1):S74.

Kalra P, Kachhwaha CP, Singh HV. Prevalence of gestational diabetes mellitus and its outcome in western Rajasthan. Indian J Endocrinol Metab. 2013;17(4):677.

Sharma K, Wahi P, Gupta A, Jandial K, Bhagat R, Gupta R et al. Single glucose challenge test procedure for diagnosis of gestational diabetes mellitus: a Jammu cohort study. J Assoc Physicians India. 2013;61(8):558-9.

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

Nanda SS, Dash K, Dash S, Misra S, Das S. Screening of gestational diabetes mellitus with 75gm OGTT and its effects on feto-maternal outcome. Screening. 2014;2:340-4.

Hadaegh F, Tohidi M, Harati H, Kharandish M and rahimi S. Prevalence of gestational diabetes mellitus in Southern Iran (Bandar Abbas City). Endocr Pract 2005;11:313-8.

Hoseini S, Hantoushzadeh S, Shoar S. Evaluating the extent of pregravid risk factors of gestational diabetes mellitus in women in Tehran. Iran Red Crescent Med J. 2011;13:407-14.

Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract. 2005;69(3):279-86.

Jacobson JD, Cousins L. A population-based study of maternal and perinatal outcome in patients with gestational diabetes. Am J Obstet Gynecol. 1989;161(4):981-6.

Langer O, Yogev Y, Most O, Xenakis EM. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol. 2005;192(4):989-97.

Adams KM, Li H, Nelson RL, Ogburn PL, Danilenko-Dixon DR. Sequele of unrecognized gestational diabetes. Am J Obstet Gynecol 1998;178(6):1321-6.

Ingrid Os, Hanson Ulf, Anders B, Ragnhild H, Nord E, Elisabeth N et al. Maternal and fetal outcomes if gestational impaired glucose tolerance is not treated. Diabetes Care. 2003;26(7):2107-111-24.

Dittakarn Boriboonhirunsarn MD, Talungjit P, Sunsaneevithayakul P. Adverse pregnancy outcomes in gestational diabetes mellitus. J Med Assoc Thai. 2006;89(4):S23-8.

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Published

2017-08-28

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Original Research Articles