Comparison of maternal and fetal outcomes in gestational diabetes mellitus diagnosed either by oral glucose tolerance test or diabetes in pregnancy study group India

Authors

  • Somya Sinha Department of Obstetrics and Gynecology, King Edward Memorial Hospital, Mumbai, Maharashtra, India
  • Niranjan M. Mayadeo Department of Obstetrics and Gynecology, King Edward Memorial Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20174436

Keywords:

DIPSI, Gestational diabetes mellitus, Oral glucose tolerance test

Abstract

Background: The optimal strategy for screening and diagnosis of Gestational Diabetes Mellitus (GDM) is still controversial and elusive. There is possibility of difference in maternal and fetal outcome depending on the diagnostic method used. This study throws light on the efficacy of two screening tests “Oral Glucose Tolerance Test’’ and “Diabetes in Pregnancy Study Group India” and to know maternal and fetal outcome in pregnancy complicated by GDM in Indian setting.

Methods: Depending on the diagnostic method used 100 GDM patients were divided in 2 groups: 1. OGTT, 2. DIPSI. Maternal outcomes were measured in terms of pregnancy induced hypertension, polyhydramnios, preterm labour, genital tract injury and methods of termination of pregnancy, gestational age at delivery. Congenital malformation, macrosomia, hypoglycemia, hyperbilirubinimia, respiratory distress, duration of NICU stay was studied in newborns.

Results: 22% of DIPSI group and 26% of OGTT group had PIH as comorbidity. Preterm delivery was noted in 22% of DIPSI group and 30% of OGTT group. 50% patients of both the groups underwent LSCS. No intrapartum complications were seen in 82% of patients. Malformations were noted in 18% of DIPSI group and 14% of OGTT group. In DIPSI group 14% of baby had macrosomia compared to 10% and in that of OGTT group.

In neonates, hypoglycaemia, respiratory distress syndrome and hyperbilirubinemia seen in 46.8%, 31% and 42.6% respectively in DIPSI group compared to 50%, 45.5% and 47.7% respectively in OGTT group.

Conclusions: No statistically significant difference was noted with respect to maternal and fetal outcomes between the two groups.

References

Cunningham FGy, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Diabetes. In, Williams Obstetrics, 23rd Edition. New York, Mc Graw Hill Medical Publisher. 2010;1104-25.

Beischer NA, Oats JN, Henry OA, Sheedy MT, Walstab JE. Incidence and severity of gestational diabetes mellitus according to country of birth in women living in Australia. Diabetes. 1991;40 Suppl 2:35-8.

Dornhost A, Paterson CM, Nicholls JS, Wadsworth J, Chiu DC, Elkeles RS, et al. High prevalence of GDM in women from ethnic minority groups. Diabetic Med. 1992;9:820-2.

American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin, authors. Clinical management guidelines for obstetrician-gynecologists. Number 30, September 2001 Gestational diabetes. Obstet Gynecol. 2001;98:525-38.

Mitanchez D, Yzydorczyk C, Siddeek B, Boubred F, Benahmed M, Simeoni U. The offspring of the diabetic mother–short-and long-term implications. Best Practice Res Clinic Obstetr Gynaecol. 2015;29(2):256-69.

Barbour LA. Unresolved controversies in gestational diabetes: implications on maternal and infant health. Curr Opin Endocrinol Diabetes Obes. 2014 Aug;21(4):264-70.

Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S. Gestational diabetes mellitus-guidelines. JAPI. 2006;54:622-2.

Government of India, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi. (DO No. M-12015/93/2011-MCH/2011).

Saxena P, Tyagi S, Prakash A, Nigam A. Pregnancy Outcome of Women with Gestational Diabetes in a Tertiary Level Hospital of North India Indian J Community Med. 2011;36(2):120-3.

Wahi, Prevalence of Gestational Diabetes Mellitus (GDM) and its Outcomes in Jammu Region, J Assoc Physicians India, 2011;59:227-30.

Xiong X, Saunders LD, Wang FL, Demianczuk NN. Gestational diabetes mellitus: Prevalence, risk factors, maternal and infant outcomes. Int J Gynaecol Obstet. 2001;75:221-8.

Bhat M, Ramesha KN, Sarma SP, Sangeetha Menon SC, Kumar G. Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in south India. Internat J Diabetes in developing countries. 2010;30(2):91

Mahalakshmi MM. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India. Indian J Endocrinol Metab. 2014;18(3):400-6.

Yajnik CS, Kale SD, Kulkarni SR, Meenakumari K, Joglekar AA, Khorsand N, et al. High risk of diabetes and metabolic syndrome in Indian women with gestational diabetes mellitus. Diabetes Medicine 2004;21:1257-9.

Casey BM, Lucas MJ, McIntire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997;90:869-73.

Jensen DM, Damm P, Sorensen B, Molsted-Pedersen L, Westergaard JG, Klebe J, et al. Clinical impact of mild carbohydrate intolerance in pregnancy: a study of 2904 nondiabetic Danish women with risk factors for gestational diabetes mellitus. Am J Obstet Gynecol. 2001;185:413-9.

Aberg A, Rydhstroem H, Frid A. Impaired glucose tolerance associated with adverse pregnancy outcome: a population-based study in southern Sweden. Am J Obstet Gynecol. 2001;184:77-83.

Kraïem J, Chiha N, Bouden B, Ounaïssa F, Falfoul A. The delivery of macrosomic infants weighing 4500 g and more. A report of 61 cases. La Tunisie Medicale. 2004;82(7):656-61.

Cypryk K, Szymczak W, Czupryniak L, Sobczak M, Lewiński A. Gestational diabetes mellitus-an analysis of risk factors. Endokrynologia Polska. 2008;59(5):393-7.

Najafian M, Cheraghi M. ccurrence of Fetal Macrosomia Rate and Its Maternal and Neonatal Complications: A 5-Year Cohort Study, ISRN Obstet and Gynecol. 2012:2012:5.

Balaji V, Anjalakshi C and Seshiah V. Diagnosis of gestational diabetes mellitus in Asian-Indian women. Indian J Endocrinol Metab. 2011;15(3):187-90.

Shefali AK, Pregnancy Outcomes in Pre-gestational and Gestational Diabetic Women in Comparison to Non-diabetic Women A Prospective Study in Asian Indian Mothers, J Assoc Physicians India. 2006;54:613-8.

Mitanchez D. Foetal and neonatal complications in gestational diabetes: perinatal mortality, congenital malformations, macrosomia, shoulder dystocia, birth injuries, neonatal complications. Diabetes Metab. 2010;36:617-27.

Malak M. Al-Hakeem, pregnancy outcome of gestational diabetic mothers: experience in a tertiary center. J Fam Community Med. 2006;13(2):55-9.

Downloads

Published

2017-09-23

Issue

Section

Original Research Articles