Screening for gestational diabetes mellitus by two step method and the neonatal outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20193631Keywords:
Gestational diabetes mellitus, Lower segment cesarean section, Macrosomia, Neonatal hyperbilirubinemia, Neonatal outcome, Neonatal hypoglycemiaAbstract
Background: As Indian women has increased risk of developing GDM, screening for GDM is essential for early diagnosis and treatment and hence to reduce the adverse neonatal outcomes.
Methods: The antenatal women are screened for GDM by administering 50g GCT and the screening test value of >130mg/dl measured at 1 hours were considered screening test positive and subjected to standard 2 hour 75gm OGTT and the neonatal outcome were observed in relation to neonatal birth weight, Apgar, and the occurrence of complications like hypoglycemia, hypocalcemia, hyperbilirubenemia.
Results: The average neonatal birth weight in the study population was 3kg. The women with GDM who required diet alone had average neonatal birth weight of 2.9kgs and the GDM women who were on diet and insulin therapy had average neonatal birth weight of 3.4kg. There was increased incidence of hyperbilirubinemia 33.3% .There was only 1 preterm birth.
Conclusions: There is association with neonatal Complications like hyperbilirubenemia and hypoglycemia with women who had screening positive for GDM.
References
Lee AJ, Hiscock RJ, Wein P, walker SP, Permezel M. Gestational diabetes mellitus: clinical predictors and long term risk of developing type 2 diabetes: a retrospective cohort study using survival analysis. Diabetes Care. 2007;30:878-83.
Seshaiah V, Balaji V, Balaji S, Sekar A, Sanjeevi CB, Green A. Gestational diabetes in India. J assoc Physicians India. 2004;52:707-11.
Metzger BE. The HAPO study co-operative research group: hyperglycemia and adverse pregnancy outcome (HAPO) study: associations with neonatal anthropometrics. Diabetes. 2009;58(2):453-9.
Major CA, Henry MJ, Deveciana M, Morgan MA. The effects of carbohydrate restriction in patients with diet controlled gestational diabetes. Obstet Gynecol. 1998;91:600-4.
Balaji V, Balaji M, Anjalakshi C, Cynthia A, Arthi T, Seshiah V. Diagnosis of gestational diabetes mellitus in Asian - Indian women. Indian J Endocrinol Metab. 2011;15(3):187-90.
Coustan, Donald RMD. Making the diagnosis of GDM (diabetes and pregnancy). Clinobstet Gynecal. 2000;43:99-105.
Albetrik, Zimmett P, WHO consultation, definition, diagnosis and classification of diabetes mellitus and its complications. Diabet Med. 1998;15:539-53.
Anjalakshi C, Seshiah V, Balaji V. A single test procedure to diagnose GDM. Acta Diabetol. 2009;46(1):51-4.
Diagnostic Criteria and Classification of Hyperglycaemia first detected in pregnancy: a WHO guideline. Diabetes Res Clinpract. 2014;103(3):341-63.
Seshiah V, Balaji V, Shah N. Diagnosis of GDM in the community. J Assoc Physicians India. 2012;60:15-7.
Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S. Gestational diabetes mellitus – guidelines. JAPI. 2006;54:622-8.
