Study on maternal and foetal outcome of pregnancy with positive glucose tolerance test by diabetes in pregnancy study group diagnostic criteria

Authors

  • G. Anantha Lakshmi Satyavathi Department of Obstetrics and Gynaecology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
  • Chitti Sudha A. Department of Obstetrics and Gynaecology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193634

Keywords:

Diabetes in pregnancy study group, Gestational diabetes mellitus, India, Pregnant women, Risk factors

Abstract

Background: Diabetes in Pregnancy Study group, India (DIPSI) diagnostic criteria is a single step method of screening and diagnosis of gestational Diabetes. Therefore, this prospective study was undertaken to ascertain the validity of DIPSI criteria to diagnose GDM based on pregnancy outcome in Indian population.

Method: The present Hospital based prospective study was conducted at OBGY department, GSL Medical College and General Hospital, Rajahmundry during 2013 to 2015. Women who were attending OBGY OPD for Antenatal check-ups within 24-28 weeks of GA during the study period were included in the study. Each mother at 24-28 weeks of gestation irrespective of last meal timing, fasting / non fasting was given 75 gm glucose dissolved in a glass of 200 ml water to drink and after two hours venous blood was collected.

Result: Out of 500 cases, 26 cases are diagnosed as having gestational diabetes by DIPSI criteria and 474 cases are Normal glucose tolerant. Maximum number 53.9% of cases diagnosed as GDM by DIPSI are of age >25 yrs (53.9%), primigravida (65.7%), BMI>25 (57.7%). In present study, family h/o diabetes is a risk factor for GDM

Conclusion: Our results suggest that a policy of universal screening for GDM should be adopted in all antenatal clinics and 75 gm OGTT has a high predictive value. This single step procedure is a simple economic and feasible method. It serves both for the purpose of screening and diagnosis at the same time.

 

References

Albert RE. Diabetes in pregnancy. Obstetrics and Gynecology. Clinics of North America. W.B. Saunders company. 1996,23(1):10.

Dornhost A, Rossi M. Risk and prevention of Type 2 Diabetes in women with gestational diabetes. Diabetes Care. 1998;21(2):B43-9.

Davey RX, Hamblin PS. Selective versus universal screening for gestational diabetes mellitus: An evaluation of predictive risk factors. Med J Aust. 2001 Feb;174(3):118-21.

Opara PI, Jaja T, Onubogu UC. Morbidity and mortality amongst infants of diabetic mothers admitted into a special care baby unit in Port Harcourt, Nigeria. Ital J Pediatr. 2010 Dec;36(1):77.

Dornhorst A, Paterson CM, Nicholls JS, Wadsworth J, Chiu DC, Elkeles RS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabetic Medicine. 1992 Nov;9(9):820-5.

Hunt K, Schuller K. The increasing prevalence of Diabetes in pregnancy obstet gynecol clin North Am. 2007:34(2):173-7.

Seshaiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational Dabetes in India. J Assoc Physicians India. 2004 Sep;52:707-11.

Balaji V, Balaji M, Anjalakshi C, Cynthia A, Arthi T, Seshiah V. Diagnosis of gestational diabetes mellitus in Asian-Indian women. Indi J endocrinol Metaboli. 2011 Jul;15(3):187-90.

Routine screening for gestational diabetes mellitus in pregnancy. SOGC Committee Opinion no.1. J Obstet Gynaecol Can; 1992.

O'Sullivan JB, Mahan CM, Charles D, Dandrow RV. Screening criteria for high-risk gestational diabetic patients. Am J Obstetr Gynecol. 1973 Aug 1;116(7):895-900.

Coustan DR, Nelson C, Carpenter MW, Carr SR, Rotondo L, Widness JA. Maternal age and screening for gestational diabetes: a population-based study. Obstet Gynecol. 1989;73(4):557-61.

Naylor CD, Sermer M, Chen E, Farine D. Selective screening for gestational diabetes mellitus. Toronto Trihospital Gestational Diabetes Project Investigators. N Engl J Med. 1997;337(22):1591-6.

Danilenko-Dixon DR, Van Winter JT, Nelson RL, Ogburn Jr PL. Universal versus selective gestational diabetes screening: application of 1997 American Diabetes Association recommendations. Am J Obstetr Gynecol. 1999 Oct 1;181(4):798-802.

Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, et al. Prevalence of gestational diabetes mellitus (GDM) and its outcomes in Jammu region. J Assoc Physicians India. 2011 Apr;59(4):227-30.

Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S. Gestational diabetes mellitus-guidelines. JAPI. 2006 Aug;54:622-8.

Bhattacharya C, Awasthi RT, Kumar S, Lamba PS. Routine screening for gestational diabetes mellitus with glucose challenge test in antenatal patients. J Obstet Gynaecol India. 2001;51:75-8.

Danilenko-Dixon DR, Van Winter JT, Nelson RL, Ogburn Jr PL. Universal versus selective gestational diabetes screening: application of 1997 American Diabetes Association recommendations. Am J Obstetr Gynecol. 1999 Oct 1;181(4):798-802.

Gestational diabetes mellitus in India. J Assoc Physicians India 2004 sep;52:707-11.

Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI, et al. Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian Subcontinent. Diabetes Res Clin Pract. 2004 Nov 1;66(2):139-45.

Granat M, Sharf M, Copper A. Glucose intolerance during pregnancy. Obstet Gynecol, 1979,53:157-61.

Jang HC, Min HK, Lee HK, Cho NH, Metzger BE. Short 24. stature in Korean women: a contribution to the multifactorial predisposition to gestational diabetes mellitus. Diabetologia. 1998 Jun 1;41(7):778-83.

Martin RW: Diabetes mellitus associated with preg-nancy. Manual of clinical problems in obstetrics and Gynecology. Ed. Rivlin ME, Martin RW, Little Brown and Company, 4th Edition, Boston, New York, Toronto, London. 1994,73-74.

Nagy G. Postprandial blood glucose screening for gestational diabetes. Zentralb Gynakol, 1993;115(1):36-40.

Hadaegh F, Tohidi M, Harati H, Kharandish M, Rahimi S. Prevalence of gestational diabetes mellitus in Southern Iran. Endocr Pract. 2005 Aug 26;11(5):313-8.

Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Prevalence of gestational diabetes mellitus in South India (Tamil Nadu)- a community based study. J Assoc Physicians India. 2008 May;56:329-33.

Swami SR, Mehetre R, Shivane V, Bandgar TR, Menon PS, Shah NS. Prevalence of carbohydrate intolerance of varying degrees in pregnant females in western India (Maharashtra) - A hospital-based study. J Indian Med Assoc. 2008;106(11):712-4.

Kim C, Liu T, Valdez R, Beckles GL. Does frank diabetes in first degree relatives of a pregnant woman affect the likelihood of her developing gestational diabetes mellitus or nongestational diabetes? Am J Obstet Gynecol. 2009 Dec 1;201(6):576-e1.

Gasim T. Gestational Diabetes Mellitus: Maternal and Perinatal outcome in 220 Saudi women. A prospective Study. Oman Med J. 2012 Mar;27(2):140-4.

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.

Joffe GM, Esterlitz JR, Levine RJ, Clemens JD, Ewell MG, Sibai BM, et al. The relationship between abnormal glucose tolerance and hypertensive disorders of pregnancy in healthy nulliparous women. Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol. 1998;179(4):1032-7.

Yogev Y, Xenakis EM, Langer O. The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. Am J Obstet Gynecol. 2004;191(5):1655-60.

Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes research and clinical practice. 2005 Sep 1;69(3):279-86.

Vink JY, Poggi SH, Ghidini A, Spong CY. Amniotic fluid index and birth weight: Is there a relationship in diabetes with poor glycemic control? Am J Obstet Gynecol. 2006;195(3):848-50.

Dashe JS, Nathan L, Mclntire D, Leveno K. Correlation between amniotic fluid glucose concentration and amniotic fluid volume in pregnancy complicated by diabetes. Am J Obstet Gynecol. 2000 Apr;182(4):901-4.

Hedderson MM, Ferrara A, Sacks DA. Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. Obstet Gynecol. 2003 Oct 1;102(4):850-6.

Yogev Y, Langer O. Spontaneous preterm delivery and gestational diabetes: the impact of glycemic control. Arch Gynecol Obstet. 2007 Oct 1;276(4):361-5.

Malak M. Al-Hakeem. Pregnancy outcome of getational diabetic mother: experience in a tertiary centre. Journal of family and community medicine 2006;13(2).

Yogev Y, Ben-Haroush A, Chen R, Glickman H, Kaplan B, Hod M. Active induction management of labor for diabetic pregnancies at term; mode of delivery and fetal outcome--a single center experience. Eur J Obstet Gynecol Reprod Biol. 2004;114(2):166-70.

Mathew M, Saquib S, Rizvi SG. Polyhydramnios. Risk factors and outcome. Saudi Med J. 2008;29(2):256-60.

Chen KC, Liou JD, Hung TH, Kuo DM, Hsu JJ, Hsieh CC, et al. Perinatal outcomes of polyhydramnios without associated congenital fetal anomalies after the gestational age of 20 weeks. Chang Gung Med J. 2005;28(4):222-8.

Ehrenberg HM, Mercer BM, Catalano PM. Catalano, the influence of obesity and diabetes on the prevalence of macrosomia, Am J Obstet Gynecol. 2004 Sep;191(3):964-8.

Tehrani FH, Kazemi H, Kordi M. Prevalence and outcome of the macrosomic infants. Acta Medica Iranica. 2007;45(6):505-9.

Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. Eur J Obstetr Gynecol Reproduc Biol. 2003 Nov 10;111(1):9-14.

Vedavathi KJ, Swamy RM, Shekharappa KR, Venkatesh G, Veerananna HB. Influence of Gestational Diabetes Mellitus on Fetal growth parameters. Int J Biol Med Res. 2011;2(3):832-4.

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Published

2019-08-26

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Original Research Articles