Materno-Fetal and Neonatal Complications of Diabetes in Pregnancy: A Retrospective Study

Abstract

The aim of this case–control study was to evaluate maternal–fetal and neonatal clinical outcomes in a group of patients with gestational diabetes mellitus (GDM) and pregestational diabetes such as diabetes mellitus type 1 (DM1) and diabetes mellitus type 2 (DM2) and compare them with those of patients without diabetes. A total of 414 pregnant women, nulliparous and multiparous, with single pregnancy were recruited. The selected patients were divided into two groups. Among 207 patients (group cases), 183 had GDM and 24 pregestational diabetes (of which n = 17 diagnosed with DM1 and n = 7 with diagnosis of DM2). Two-hundred-seven patients with a negative pathologic history of GDM, DM1 and DM2 represented the population of controls (group control). We reported an incidence of preterm delivery of 23.2% in the group of cases, of 18.3% in the group of patients with GDM and 66.7% in the group of patients DM1/2. Fetal growth disorders, such as intrauterine growth retardation (IUGR), small for gestational age (SGA), fetal macrosomia, were detected in four fetuses out of 207 (1.93%) in the control group and 20 fetuses out of 207 in the case group (9.67%, p-value 0.001); of these 16 of 183 fetuses of the GDM group (8.74%, p-value 0.002) and 4 of 24 fetuses of the DM1/2 group (16.67%, p-value 0.005). A very strong correlation between diabetes mellitus type 1 and preeclampsia (p-value < 0.0001) was observed. Close monitoring of pregnant women with diabetes is recommended to prevent maternal–fetal and neonatal complications.

Perinatal and neonatal outcomes of pregestational diabetes mellitus: a retrospective study

“…Diabetic patients had a pregravidic body weight higher than that of the patients in the control group and the median pregravidic BMI differed by 1.7 points between cases and controls. In agreement with other studies [3][4][5][6][7][8], the increase in pre-pregnancy BMI corresponded to a lower weight gain during pregnancy, probably linked to a greater dietary and behavioral control [14]. However, BMI at delivery was signi cantly higher in diabetic patients; dietary behavioral control was apparently not su cient to reverse the differences with the control group.…”

“…The Italian region Sardinia has an incidence rate of DM1 equal to 33.4 per 100,000, which is the second highest globally [2]. Pre-gestational diabetes is associated with adverse neonatal outcomes [3].…”

Interventricular Septal Thickness as a Diagnostic Marker of Fetal Macrosomia

“…Factors predisposing to macrosomia can be divided into three groups: maternal, gestational, and fetal. Among the main maternal risk factors are pre-gestational or gestational diabetes and a positive history of macrosomia in previous pregnancies [ 2 , 3 , 4 , 5 ]. As shown in Figure 1 , fetal factors include gender, genetics, and certain medical conditions [ 1 , 6 ].…”

A systematic review on outcome reporting in randomised controlled trials assessing treatment interventions in pregnant women with pregestational diabetes

“…Vincent declaration (1989), stating that pregnancy outcomes in women with diabetes should approximate that of women without diabetes, has not been achieved 2 . PGDM is associated with increased morbidity to both mother and baby including preterm birth, small (SGA) and large for gestational age (LGA), macrosomia, congenital malformations and pre-eclampsia (PET) 3 .…”