Association of oral glucose tolerance test and pregnancy and fetal outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20204434Keywords:
Gestational diabetes mellitus, Prevalence, Feto-maternal outcome, Oral glucose tolerance test, Glycaemic controlAbstract
Background: Gestational diabetes mellitus (GDM) affects 2-25% of pregnancies depending on population characteristics and criteria used. It is associated with an increased risk of fetal malformation and perinatal mortality. The aim of the study was to know the prevalence of GDM, the risk factors associated with women with GDM and the feto-maternal outcome.
Methods: A prospective study conducted among 200 antenatal women attending Obstetrics and Gynaecology (OBG) Outpatient Department in A. J. Institute of Medical Sciences and Research Center from March 2019 to August 2019. GDM was diagnosed with 2-hour 75 gm oral glucose tolerance test according to diabetes in pregnancy study group of India (DIPSI) criteria. Basic demographic details and maternal and fetal outcomes were analysed.
Results: The prevalence of GDM was high (24.5%) compared to other studies. Normoglycemia was achieved with diet alone in 71.5%, diet and metformin in 16.3% and 12.2% with insulin. Risk factors included higher body mass index (BMI) and history of GDM. Emergency caesarean rate was higher among GDM women (p<0.05). Fetal complications and neonatal intensive care unit (NICU) admissions were also higher in this group (p<0.001 and p<0.05).
Conclusions: The higher prevalence shows the importance of early detection and timely intervention for pregnancy complicated with GDM. Due to this high-risk pregnancy, there’s increased incidence of maternal and fetal outcomes which can be reduced with glycaemic control and adequate fetal surveillance.
References
Buckley BS, Harreiter J, Damm P, Corcoy R, Chico A, Simmons D, et al. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabetes Med. 2012;29:844-54.
Sacks DA, Hadden DR, Maresh M, Deerochanawong C, Dyer AR, Metzger BE, et al. Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Diabetes Care. 2012;35:526-8.
O’Sullivan JB, Charles D, Mahan CM, Dandrow RV. Gestational diabetes and perinatal mortality rate. Am J Obstet Gynecol. 1973;116(7):901-4.
Harris MI. Gestational diabetes may represent discovery of pre-existing glucose intolerance. Diabetes Care. 1988;11:402-11.
Mitanchez D. Foetal and neonatal complications in gestational diabetes: perinatal morbidity, congenital malformations, macrosomia, shoulder dystocia, birth injuries, neonatal complications. Diabetes Metab. 2010;36:617-27.
Buckley BS, Harreiter J, Damm P, Corcoy R, Chico A, Simmons D, et al. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabetes Med. 2012;29:844-54.
Nankervis A, McIntyre H, Moses R. ADIPS consensus guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia, 2014. Available at: http://www.adips.org/downloads/2014 ADIPSGDMGuidelinesV18.11.2014_000.pdf. Accessed on: 25 June 2020.
Kim YS, England L, Wilson GH. Percentage of Gestational Diabetes Mellitus Attributable to Overweight and Obesity. Am J Pub Health. 2010;100(6):1047-52.
Moosazadeh M, Asemi Z, Lankarani KB. Family history of diabetes and the risk of gestational diabetes mellitus in Iran: A systematic review and meta-analysis. Diabetes Metab Syndr. 2017;11(1):99-104.
Society of Maternal-Fetal Medicine (SMFM) Publications Committee. SMFM Statement: Pharmacological treatment of gestational diabetes. Am J Obstet Gynecol. 2018;218(5):B2-4.
Tania R. Leading Cause of Primary Cesarean Delivery in Diabetic Women Is Failed Induction. Obstet Gynecol. 2020;135(1):44-5.
Alia A, Ahmad R, Husain M. Feto-Maternal Complications in Gestational Diabetes and in Pre-Existing Diabetes Mellitus. Medical Forum. 2020;31(4):45-9.
Shefali AK, Kavitha M, Deepa R, Mohan V. Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to non-diabetic women—A prospective study in Asian Indian mothers (CURES-35). J Assoc Physicians India. 2006;54:613-8.
Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 180: Gestational Diabetes Mellitus. Obstet Gynecol. 2017;130:17-37.
Fadda GM, D’Antona D, Ambrosini G, Cherchi PL, Nardelli GB, Capobianco G, Dessole S. Placental and fetal pulsatility indices in gestational diabetes mellitus. J Reprod Med. 2001;46:365-70.
Garne E, Loane M, Dolk H. Spectrum of congenital anomalies in pregnancies with pregestational diabetes. Birth Defects Res. Part A Clin. Mol Teratol. 2012;94:134-40.
Parimi M, Nitsch D. A Systematic Review and Meta-Analysis of Diabetes during Pregnancy and Congenital Genitourinary Abnormalities. Kidney Int Rep. 2020;5:678-93.
