Universal screening for gestational diabetes mellitus with diabetes in pregnancy study group India criteria and maternal and fetal outcome in gestational diabetes mellitus patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242942Keywords:
GDM, Fetomaternal outcome, Universal screeningAbstract
Background: The aim of the study was to estimate the incidence of gestational diabetes mellitus (GDM) among antenatal patients and to evaluate the maternal and neonatal complications in GDM cases and compare it with non GDM controls.
Methods: This prospective study was conducted at Bebe Nanki maternal and child care centre, Amritsar in the department of obstetrics and gynecology from September 2022 to August 2023. A total of 2600 antenatal patients were screened for GDM using DIPSI (diabetes in pregnancy study group India) criteria. Maternal and fetal outcomes were compared in 200 GDM cases and 200 non GDM controls.
Results: Incidence of GDM was found to be 8.69% (226/2600). The mean age of GDM cases v/s controls was 29±5.53 years v/s 26.75±4.55 years respectively. Mean BMI of GDM cases v/s controls was ≥24 kg/m2 v/s 18.5-23.9 kg/m2. Majority of GDM cases 117 (58.5) and controls 140(70%) delivered at term via LSCS (53% cases v/s 49.5% controls delivered via LSCS). Antenatal complications like HDP (17.5% v/s 8%), preterm labour (40.5% v/s 29.5%) and polyhydroamnios (19.5% v/s 1.5%) were more common among GDM cases v/s controls. Surgical site infections (11% v/s 2.5%) and UTI (24% v/s 6%) incidence was higher in GDM cases compared to controls. Neonatal complications like NICU admission (21% v/s 7.5%), sepsis (12% v/s 5.5%) and hypoglycaemia (37.5% v/s 1%) were higher in infants of GDM mothers.
Conclusions: Early detection and timely management of GDM cases can improve foetomaternal outcome.
References
Arias' Practical Guide to High-Risk Pregnancy and Delivery;5th edition: Diabetes in Pregnancy. 2019;238-50
International Diabetes Federation (IDF). Atlas 9th Edn. Online version of IDF Diabetes Atlas. 2019;570-612. www.diabetesatlas.org. Accessed on 05 April 2024.
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 Reproduct Contracept Obstetr Gynecol. 2014;3(1):219-25.
Barbour LA, Boggess K, Do Castorino KR, Chartier-Logan CA, Durnwald CP, Hadar E. Gestational diabetes mellitus. Med Care Pregnant Patient. 2007;1:218.
Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA. Longitudinal changes in insulin release and insulin resistance in non-obese pregnant women. American J Obstet Gynecol. 1991;165:1667-72.
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 Physicians India, 2008;56:329-33.
Li Y, Ren X, He L, Li J, Zhang S, Chen W. Maternal age and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of over 120 million participants. Diabetes Res Clin Pract. 2020;162:108044.
Sitorukmi G, Dewi YL, Murti B. Meta-Analysis: Effects of Obesity and Family History of Diabetes Mellitus on the Risk of Gestational Diabetes Mellitus. Indonesian J Med. 2021;6(1):1-3.
Moon JH, Lee J, Kim KH, Kim HJ, Kim H, Cha HN, Park J, Lee H, Park SY, Jang HC, Kim H. Multiparity increases the risk of diabetes by impairing the proliferative capacity of pancreatic β cells. Experimental Molecular Med. 2023;55(10):2269-80.
Kumari R, Dalal V, Kachhawa G, Sahoo I, Khadgawat R, Mahey R, et al. Maternal and perinatal outcome in gestational diabetes mellitus in a tertiary. Indian J Endocrinol Metab. 2018;22(1):116-20.
Dudhwadkar AR, Fonseca MN. Maternal and fetal outcome in gestational diabetes mellitus. Int J Reproduct Contracept Obstetr Gynecol. 2016;5(10):3317-22.
Pandey U, Agrawal NK, Agrawal S, Batra S. Outcome of diabetic pregnancies in a tertiary referral centre, Varanasi. J Obstetr Gynecol India. 2016;66:226-32.
Phoswa WN, Khaliq OP. The role of oxidative stress in hypertensive disorders of pregnancy (preeclampsia, gestational hypertension) and metabolic disorder of pregnancy (gestational diabetes mellitus). Oxid Med Cell Longev. 2021;2021:5581570.
McElwain CJ, Tuboly E, McCarthy FP, McCarthy CM. Mechanisms of endothelial dysfunction in pre-eclampsia and gestational diabetes mellitus: windows into future cardiometabolic health? Front Endocrinol. 2020;11:655.
Dahiya K, Sahu J, Dahiya A. Maternal and fetal outcome in gestational diabetes mellitus-a study at tertiary health centre in Northern India. Library J. 2014;1(03):1.
Khan R, Ali K, Khan Z. Maternal and fetal outcome of gestational diabetes mellitus. Gomal J Med Sci. 2013;11(1):10.
Sweeting AN, Ross GP, Hyett J, Molyneaux L, Constantino M, Harding AJ, et al. Gestational diabetes mellitus in early pregnancy: evidence for poor pregnancy outcomes despite treatment. Diabetes care. 2016;39(1):75-81.
Makwana M, Bhimwal RK, Ram C, Mathur SL, Lal K, Mourya H. Gestational diabetes mellitus with its maternal and foetal outcome: a clinical study. Int J Adv Med. 2017;4(4):919-25.
Lucas IM, Barr EL, Barzi F, Longmore DK, Lee IL, Kirkwood M, et al. Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the pandora study: A prospective cohort. Int J Gynecol Obstetr. 2021;155(2):296-304.
Muche AA, Olayemi OO, Gete YK. Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia. BMC Pregnancy Childbirth. 2020;20:1-3.
Al-Bash MR, Mathew M, Al-Kharusi LA, Abu-Heija AT. Symptomatic urinary tract infection in diabetic pregnant women, effect of the type of diabetes and glycemic control. Saudi J Med Med Sci. 2016;4(2):104-7.
Gajjar F, Maitra K. Intrapartum and perinatal outcomes in women with gestational diabetes and mild gestational hyperglycemia. J Obstet Gynaecol India. 2005;55:135-7.
Hod M, Merlob P, Friedman S, Schoenfeld A, Ovadia J. Gestational diabetes mellitus: a survey of perinatal complications in the 1980s. Diabetes. 1991;40(2):74-8.
