1382-P: Does Tight Gestational Diabetes Mellitus Control Have an Impact on the Maternal and Neonatal Outcome Compared with General Populations? Which Factors Predict the Adverse Pregnancy Outcomes?

Abstract

The prevalence of adverse outcomes in GDM pregnancies compared to the general population are still high in studies, which used ADA treatment criteria. Our goal was to compare outcomes of tight controlled GDM pregnancies achieving optimal glycemic patterns with normal pregnancies. A cross-sectional study of 280 singleton pregnancies: 140 GDM with a mean FBG ≤90 and 1h PP ≤ 120mg/dL vs. 140 normal pregnancies, age and BMI matched. FBG and 1h PP BG for each participant was determined by the average of their SMBG readings. Clinical characteristics - age: 35.7±5 vs. 35.4±5 years; BMI: 23.1±5 vs. 23.7±4 kg/m2; OGTT 0’: 94.1±14.4, 60’: 186.1±27.7, 120’: 161,2±20.4 mg/dL; HbA1c: 5.2±0.6 vs. 4.8±0.3 %, p<0.001; FBG: 83.7±8 mg/dl; 1h PP BG: 106.5±11 mg/dl; GDM diagnosis week: 25.8±4; starting insulin week: 26.8±5; insulin dose: 46.3±13 iu/day. Obstetric and neonatal history between groups: Weight gain: 11.8±4 vs. 10.4±2 kg, p=0.03; delivery week: 37.7±2 vs. 38.1±1, p=0.01; neonatal birth weight: 3050±327 vs. 3200±355 g, p<0.001; SGA: 5.7 vs. 4.3%; LGA: 5.7 vs. 3.6 %; women hypoglycemia episodes: 21.4 %; pre-eclampsia rate: 4.2 vs. 2.8 %; RDS: 10 vs. 7.1 %; Neonatal hypoglycemia: 6.4 vs. 5.7%, NICU admittance: 17.8 vs. 6.4%, p=0.02, Caesarean section: 60 vs. 23.6 %, p<0.001. No cases of severe maternal hypoglycemia and perinatal mortality. An association between: maternal-fetal complications and increased 1h PP BG (r=303), 1h (r=348), 2h (r=228) OGTT values. No association between adverse fetal outcome and maternal hypoglycemia. Tight metabolic control with early insulin therapy minimizes adverse pregnancy outcomes. Performing GDM screenings before 24-28 weeks in women >35 years of age is recommended. Outcome of the pregnancies was not adversely affected by maternal hypoglycemia. 1h PP BG and 1h and 2h OGTT values predicts outcome in GDM pregnancies. More research is needed to understand the optimal BG targets in GDM management. Disclosure P. Thomakos: None. O. Kepaptsoglou: None. C. Barreto: None. A. Trouva: None. D. Trouvas: None. C.S.P. Zoupas: None.