Maternal and fetal outcome in gestational diabetic women
Background and objective: Gestational diabetes mellitus affects 7% of all pregnancies. It is defined as glucose intolerance that begins or is first diagnosed during pregnancy. It is crucial to detect women with gestational diabetes mellitus because the condition can be associated with several maternal and fetal complications. This study aimed to determine the maternal and fetal outcome of gestational diabetes mellitus in maternity teaching hospital in Sulaimani city, Kurdistan, Iraq.
Methods: This prospective observational study had involved 100 pregnant women with gestational diabetes mellitus. Data were collected from 1st January 2014 to 1st July 2014.
Results: Most women were in the age group 30-39 years (57%) and were multigravida (75%). Regarding women’s BMI, 69% of women had a BMI of >30 kg/m2. Most of the women delivered by cesarean section (68%). Also, 63% delivered term baby ≥ 37weeks. Of the women who used insulin, 30.6% delivered babies >4 kg. Complications occurred in 10%, 12.9%, and 11.1% of women who treated by diet, insulin, and the group used metformin then insulin, respectively.
Conclusion: The results conclude that pregnant women with gestational diabetes mellitus have increased the risk of hypertension in pregnancy, preterm delivery, and cesarean section. Increasing age, family history of diabetes, increasing parity, and increase in BMI are a risk factor for developing gestational diabetes mellitus. Also, most of the maternal complications occurred in those women who were on metformin. The occurrence of macrosomia was low in the treated cases of gestational diabetes mellitus.
Bellamy I, Casas JP, Hingorani AD, Williams D. Type 2 diabetes after gestational diabetes a systematic review and meta-analysis. Lancet 2009; 373:173–9.
American Diabetes Association. Gestational diabetes mellitus. Diabetes Care 2004; Suppl 1:S88–90.
Jovanovic L. Medical management of pregnancy complicated by diabetes. 3rd ed. Alexandria, Va. American Diabetes Association; 2000.
Metzger BE, Coustan DM. Organizing Committee. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 1998; Suppl2:B161–7.
Schmidt MI, Matos MC, Reichelt AJ, Forti Ac, de Lima L, Duncan BB. Prevalence of gestational diabetes mellitus-do the new WHO criteria makes a difference? Brazilian Gestational diabetes study group. Diabetes Med 2000; 17:376–80.
Jovanovic Peterson L, Peterson CM. Nutritional management of the obese gestational diabetic pregnant woman. J Am Coll Nutr 1992; 11:246–50.
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes. Diabetes Care 2010; 33(12):2692–6.
Hawkins JS, Casey BM. Laber and delivery management for women with diabetes. Obest Gynecol Clin North Am 2007; 34:323–34.
De Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM, et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl Med 1995; 333:1237-41.
Jovanovic LG. Using meal-based self-monitoring of blood glucose as a tool to improve outcomes in pregnancy complicated by diabetes. Endocr Pract 2008; 14:239–47.
Williams CB, Iqbal S, Zawacki CM, Yu D, Brown MB, Herman WH. Effect of selective screening for gestational diabetes. Diabetic Care 1999; 22:418–21.
Chan LY, Wong SF, Ho LC. Diabetic family history is an isolated risk factor for gestational diabetes after 30 years of age. Acta Obstet Gynecol Scand 2002; 81(2):115–7.
Botto LD, Moore CA, Hobbs CA, Correa A1, Gilboa SM, Besser LM, et al. Diabetes mellitus and birth defects. Am J Obstet Gynecol 2008; 199(3):237.
Hadaegh F, Khairandish M, Shafei R, Taohidi M. The prevalence of gestational diabetes in pregnant women in Bandar Abbas. Iran J Endocrinol Metab 2004; 6(3):225–34.
Sudhanshu SN, Karuna D, Subhalaxmi D, Sujata M, Sidhartha D. Screening of Gestational Diabetes Mellitus with 75gm OGTT and its effects on Feto-maternal Outcome. Diabetic Care 2014; 2(1C):340–2.
Zokaie M, Majlesi F, Rahimi-Foroushani A, Esmail-Nasab N. Risk factors for gestational diabetes mellitus in Sanandaj, Iran. Chron Dis J 2014; 2(1):1–9.
- Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of GDM. Obes Rev 2009; 10(2):194–203.
Casey BM, Lucas MJ, Mcintire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol 1997; 90(6):869–73.
Peled Y, Perri T, Chen R, Pardo J, Bar J, Hod M. Gestational diabetes mellitus--implications of different treatment protocols. J Pediatr Endocrinol Metab 2004; 17(6):847–52.
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.
Agarwal MM, Punnose J, Dhatt GS. Gestational diabetes implications of variation in post-partum follow-up criteria. Eur J Obst Gyn Repr Biol 2004; 113:149–53.
Declercq E, Barger M, Cabral H, Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births. Obstet Gynecol 2007; 109(3):669–77.
Kennare R, Tucker G, Heard A, Chan A. Risk of adverse outcomes in the next birth after a first cesarean delivery. Obstet Gynecol 2007; 109.
Kjos S, Berkowitz K, Kung B. Prospective delivery of reliably dated term infants of diabetic mothers without determination of fetal lung maturity: Comparison to historical control. J Mat Fetal Neonat Med 2002; 30:313–21.
Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest 2005; 115(3):485–91.
Ahkter J, Qureshi R, Rahim F, Moosvi S, Rehman A, Jabbar A, et al. Diabetes in pregnancy in Pakistani women: prevalence and complications in an indigenous South Asian community. Diabet Med 1996; 13(2):189–91.
Munim S, Chaudhury N, Jamal K, Khan FA. Outcome of abruptio placentae in normotensive and hypertensive patients in Aga Khan University Hospital, Pakistan. J Obstet Gynecol Res 1997; 23(3):267–71.
El Mallah KO, Narchi H, Kulaylat NA, Shaban MS. Gestational and pre-gestational diabetes: comparison of maternal and fetal characteristics and outcome. Int J Gynaecol Obstet 1997; 58(2):203–9.
Robin V, Binny T, Moza Al H, Abdul R, Mona Al S, Ayesha AS, et al. The prevalence, risk factors, mMaternal and fetal outcomes in gestational diabetes mellitus. Int J Drug Dev Res 2012; 4(3):356–68.
Gandhi P, Bustani R, Madhuvrata P, Farrell T. Introduction of metformin for gestational diabetes mellitus in clinical practice: has it had an impact? Eur J Obst Gyn Repr Biol 2012; 160:147–50.
Moore LE, Briery CM, Clokey D, Martin RW, Williford NJ, Bofill JA, et al. Metformin and insulin in the management of gestational diabetes mellitus: preliminary results of a comparison. J Reprod Med 2007; 52:1011–5.
- Rowan J, Hague W, Gao W, Battin M, Moore M. MiG Trial Investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med 2008; 358:2003.
Mesdaghinia E, Samimi M, Homaei Z, Saberi F, Moosavi S, Yaribakht M.n Comparison of newborn outcomes in women with gestational diabetes mellitus treated with metformin or insulin: A randomized blinded trial. Int J Prev Med 2013; 4(3):327–33.
Tertti K, Ekblad U, Vahlberg T, Rönnemaa T. Comparison of metformin and insulin in the treatment of gestational fiabetes: A retrospective, case-control study. Rev Diabet Stud 2008; 5(2):95–101.
Balani JHS, Rodin A, Shetata H. Pregnancy outcomes in metformin treated women with gestational diabetes. Diabetologia 2008; 51(Suppl 1):S467.
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