Maternal and neonatal outcome in mothers with gestational diabetes mellitus

Prakash, G; Das, Ashok Kumar; Habeebullah, Syed; Bhat, Vishnu; Shamanna, Suryanarayana Bettadpura

doi:10.4103/ijem.ijem_66_17

Cited by 46 publications

(15 citation statements)

References 21 publications

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“…A significant positive correlation with HbA1C% results was observed with maternal age, BMI, and birth weight while a significant negative correlation with HbA1C% results was observed only with gestational age. Our correlation findings are similar to those of Sweeting AN et al who stated that baseline HbA1C%>5.9% (41 mmol/mol) identifies an increased risk of large-for-gestational-age, macrosomia, cesarean section, and hypertensive disorders in standard GDM [ 47 , 48 ]. Nevertheless, a 2013 systematic review and meta-analysis of randomized trials for the US Preventive Services Task Force found that reductions in pre-eclampsia, macrosomia, and shoulder dystocia were associated with appropriate management of GDM [ 50 ].…”

Section: Discussionsupporting

confidence: 90%

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Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population

Bayoumi

Masri

Matani

et al. 2021

BMC Pregnancy Childbirth

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Background Diabetes Mellitus (DM) is a major cause of maternal, fetal, and neonatal morbidities. Our objective was to estimate the effect of both pre-pregnancy and gestational DM on the growth parameters of newborns in the Qatari population. Methods In this population-based cohort study, we compared the data of neonates born to Qatari women with both pre-pregnancy and gestational diabetes mellitus in 2017 with neonates of healthy non-diabetic Qatari women. Results Out of a total of 17020 live births in 2017, 5195 newborns were born to Qatari women. Of these, 1260 were born to women with GDM, 152 were born to women with pre-pregnancy DM and 3783 neonates were born to healthy non-diabetic (control) women. The prevalence of GDM in the Qatari population in 2017 was 24.25%. HbA1C% before delivery was significantly higher in women with pre-pregnancy DM (mean 6.19 ± 1.15) compared to those with GDM (mean 5.28 ± 0.43) (P <0.0001). The mean birth weight in grams was 3066.01 ± 603.42 in the control group compared to 3156.73 ± 577.88 in infants born to women with GDM and 3048.78 ± 677.98 in infants born to women with pre-pregnancy DM (P <0.0001). There was no statistically significant difference regarding the mean length (P= 0.080), head circumference (P= 0.514), and rate of major congenital malformations (P= 0.211). Macrosomia (Birth weight > 4000 gm) was observed in 2.7% of the control group compared to 4.8% in infants born to women with GDM, and 4.6% in infants born to women with pre-pregnancy DM (P= 0.001). Multivariate logistic regression analysis demonstrated that higher maternal age (adjusted OR 2.21, 95% CI 1.93, 2.52, P<0.0001), obesity before pregnancy (adjusted OR 1.71, 95% CI 1.30, 2.23, P<0.0001), type of delivery C-section (adjusted OR 1.25, 95% CI 1.09, 1.44, P=0.002), and body weight to gestational age LGA (adjusted OR 2.30, 95% CI 1.64, 2.34, P<0.0001) were significantly associated with increased risk of GDM. Conclusion Despite the multi-disciplinary antenatal diabetic care management, there is still an increased birth weight and an increased prevalence of macrosomia among the infants of diabetic mothers. More efforts should be addressed to improve the known modifiable factors such as women's adherence to the diabetic control program. Furthermore, pre-pregnancy BMI was found to be significantly associated with gestational DM, and this is a factor that can be addressed during pre-conceptional counseling.

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Section: Discussionsupporting

confidence: 90%

“…Those malformations were not significantly associated with any maternal or fetal parameters. Moreover, Prakash GT et al reported a 2.3% (3/132) rate of major congenital anomalies in infants born to GDM women [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population

Bayoumi

Masri

Matani

et al. 2021

BMC Pregnancy Childbirth

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“…It has previously been observed that GDM is liable to have many adverse effects on the pregnancy outcomes of pregnant women and newborns, seriously affecting the maternal and neonatal health. [7,8] In the study of Prakash et al, [9] GDM has been found to be associated with increased risk of complications among mother and newborn, including pregnant women required to take cesarean section, newborns had the high birth weight and required neonatal intensive care unit (NICU) admission. Similarly, Boriboonhirunsarn et al [10] also pointed that the incidence of emergency cesarean section in pregnant women with GDM was significantly higher than normal pregnant women, the possible reason is that GDM patients need to take cesarean sections to avoid complications of macrosomia.…”

Section: Introductionmentioning

confidence: 99%

Association between gestational diabetes mellitus and adverse obstetric outcomes among women with advanced maternal age: A retrospective cohort study

2022

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To explore the association of gestational diabetes mellitus (GDM) with maternal and neonatal adverse outcomes among women with advanced maternal age. This retrospective cohort study included 1551,140 eligible pregnant women from the National Vital Statistics System database in 2017 to 2019, and all participants were divided into two groups: GDM group (n = 154,646) and non-GDM group (n = 1396,494). Univariate and multivariate logistic regression analyses were used to assess the association of GDM and maternal and neonatal outcomes; additionally, we also adopted subgroup analysis to analyze the association in detail based on gestational weight gain (GWG) levels. The risk of each adverse outcome was presented by using odds ratio (OR) and 95% confidence interval (CI). After adjusted some covariables, GDM increased the risk of neonatal assisted ventilation (

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“…Gestational diabetes mellitus (GDM) is a common metabolic disorder of pregnancy, which has unfavorable and negative effects (e.g. occurrence of preeclampsia, macrosomia, low birth weight and preterm birth) on maternal and fetal health [1, 2]. Population studies have reported a GDM prevalence of 1–14% [3].…”

Section: Introductionmentioning

confidence: 99%

Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus: a prospective cohort study

Kouhkan

Khamseh

Pirjani

et al. 2018

BMC Pregnancy Childbirth

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BackgroundGrowing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with assisted reproductive technology (ART). However, there is little known about pregnancy related complications and co-morbidity in gestational diabetes mellitus (GDM) following singleton pregnancies achieved by ART in comparison with spontaneous conception (SC).MethodsTwo hundred sixty singleton pregnant women conceived by ART and 314 pregnant women conceived by spontaneous conception (SC) were participated in this prospective cohort study. All participants were enrolled after GDM screening through one-step oral glucose tolerance test (OGTT) and then grouped into GDM and non-GDM groups. Women were followed for pregnancy outcomes including pregnancy-induced hypertension (PIH), preeclampsia, antepartum hemorrhage (APH), cesarean section (CS), preterm birth (PTB), intrauterine growth restriction (IUGR), being small or large for gestational age (SGA or LGA), macrosomia, low birth weight (LBW), respiratory distress, neonatal hypoglycemia, NICU admission and perinatal mortality from antenatal visits to delivery. Confounding factors were adjusted in logistic regression model in order to estimate adjusted odds ratios (aORs).ResultsAmong 260 ART and 314 SC, 135 and 152 women were GDM women, respectively. Higher maternal age and pre-gravid BMI, shorter duration of gestation and lower gestational weight gain were observed in GDM groups (ART-GDM and SC-GDM) compared to those of the SC group. ART-GDM group had a higher risk (95% confidence interval) of obstetric complications including PIH [aOR:7.04 (2.24–22.15)], preeclampsia [aOR:7.78 (1.62–37.47)], APH [aOR:3.46 (1.28–9.33)], emergency CS [aOR:2.64 (1.43–4.88)], and perinatal outcomes such as PTB [aOR:3.89 (1.51–10.10)], LBW [aOR:3.11 (1.04–9.30)] and NICU admission [aOR:4.36 (1.82–10.45)], as well as neonatal hypoglycemia [aOR: 4.91 (1.50–16.07)], compared to SC group. SC-GDM group showed a higher risk of PIH [aOR: 4.12 (1.31–12.89)], emergency CS [aOR: 2.01 (1.09–3.73] and LGA [aOR: 5.20 (1.07–25.20)], compared to SC group. Additionally, ART group had a higher risk of PIH [aOR: 3.46(1.02–11.68), preeclampsia 5.29 (1.03–27.09), and NICU admission [aOR: 2.53 (1.05–6.09)] compared to SC. Insulin requirement (41.8% vs. 25.7%) was significantly higher in ART-GDM group compared to SC-GDM group.ConclusionThe findings of this study suggest that GDM occurring after ART conception increases the risk of adverse obstetric and perinatal outcomes.

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Maternal and neonatal outcome in mothers with gestational diabetes mellitus

Cited by 46 publications

References 21 publications

Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population

Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population

Association between gestational diabetes mellitus and adverse obstetric outcomes among women with advanced maternal age: A retrospective cohort study

Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus: a prospective cohort study

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