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The Journal of Obstetrics and Gynecology of India

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01-12-2012 | Original Article

Outcome of Gestational Diabetes Mellitus from a Tertiary Referral Center in South India: A Case–Control Study

Authors: Mamta Bhat, K. N. Ramesha, Sankara P. Sarma, Sangeetha Menon, S. Ganesh Kumar

Published in: The Journal of Obstetrics and Gynecology of India | Issue 6/2012

Abstract

Background

Carbohydrate intolerance is the most common metabolic complication of pregnancy. Gestational diabetes mellitus (GDM) poses numerous problems for both mother and fetus. The objective of this study was to compare the maternal and perinatal outcome between women with gestational diabetes mellitus and non-diabetic women.

Study Design

A case–control study with 286 cases and 292 age-matched controls was conducted for a period of 11 months (August 2007–June 2008) in Sree Avittom Thirunal Hospital, Thiruvananthapuram, India.

Materials and Methods

Universal screening was applied by means of glucose challenge test (GCT) using 50 g of glucose. If GCT >130 mg%, the patients were subjected to oral glucose tolerance test with 100 g of glucose. National Diabetes Data Group criteria was taken to assign patients to study group. These women were further followed up and the maternal and perinatal outcomes were assessed.

Statistical Analysis

Univariate analysis was done by means of t test, Odd’s ratio, Chi-square test, and Fisher Exact test. P < 0.05 was taken as significant.

Results

The frequency of induction of labor was significantly higher than spontaneous labor (OR = 1.84, P = 0.001). 40.1 % GDM mothers and 35.8 % of non-diabetic mothers were delivered by Cesarean section. Premature rupture of membranes (PROM) was the most common complication of labor (OR = 1.66, P = 0.04). Babies of diabetic mothers had a positive trend toward prematurity (OR = 2.3, P = 0.007). Hypoglycemia was the most common neonatal complication (OR = 11.97, P < 0.001) and nine babies of diabetic mothers were macrosomic (OR = 5.2, P = 0.02).

Conclusions

Maternal morbidities and neonatal complications such as neonatal hypoglycemia, macrosomia, and prematurity were significantly higher in GDM.

Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance in India. In: Gan D, editor. Diabetes atlas. Belgium: International Diabetes Federation; 2006. p. 15–103.

Available from: http://www.searo.who.int/EN/Section1243/Section1382/Section1386/Section1898_9438.htm. Accessed 10 Mar 2008.

World Health Organization, Regional Office for South East Asia. Health Situation in South East Asia Region (1998–2000), Regional office for SEAR New Delhi. 2002. Available from: http://www.searo.who.int/LinkFiles/Health_Situation_book.pdf. [cited in 2002]. Accessed Mar 2010.

Ahuja MM, Sivaji L, Garg VK, et al. Prevalence of diabetes in northern India (Delhi area). Horn Metab Res. 1974;4:321.CrossRef

Gupta OP, Joshi MH, Dave SK. Prevalence of diabetes in India. Adv Metab Disord. 1978;9:147–65.PubMed

Langer O, Yogev Y, Most O, et al. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol. 2005;192:989–97.PubMedCrossRef

Merlob P, Hod M. Short-term implications: the neonate. In: Hod M, Jovanovic L, Di Renzo GC, de Leiva A, Langer O, editors. Textbook of diabetes and pregnancy. 1st ed. London: Martin Dunitz; 2003. p. 289–304.

Banerjee S, Ghosh US, Banerjee D. Effect of tight glycemic control on fetal complications in diabetic pregnancies. J Assoc Physicians India. 2004;52:109–13.PubMed

Shefali AK, Kavitha M, Deepa R, et al. Pregnancy outcome pregestational and gestational diabetic women in comparison to nondiabetic women—a prospective study in Asian Indian mothers (CURES-35). J Assoc Physicians India. 2006;54:613–8.PubMed

10.

Seshiah V, Balaji V, Balaji MS, et al. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707–11.PubMed

11.

The Expert Committee on the Diagnosis and Classification of diabetes mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183–97.

12.

Metzger BE, Coustan DR. Proceedings of the fourth international workshop-conference on gestational diabetes mellitus. Diabetes Care. 1998;21(Suppl. 2):B1–167.

13.

Jensen DM, Sorensen B, Feilberg-Jorgensen N, et al. Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile. Diabet Med. 2000;17:281–6.PubMedCrossRef

14.

Schaffir JA, Lockwood CJ, Lapinski R, et al. Incidence of pregnancy-induced hypertension among gestational diabetics. Am J Perinatol. 1995;12:252–4.PubMedCrossRef

15.

Nachum Z, Ben-Shlomo I, Weiner E, et al. Twice daily versus four times daily insulin dose regimens for diabetes in pregnancy: randomised controlled trial. Br Med J. 1999;319:1223–7.CrossRef

16.

Naylor CD, Sermer M, Chen E, et al. Selective screening for gestational diabetes mellitus. Toronto Tri-Hospital Gestational Diabetes Project Investigators. N Engl J Med. 1997;337:1591–6.PubMedCrossRef

17.

Vivet-Lefébure A, Roman H, Robillard PY, et al. Obstetrical and neonatal outcomes of gestational diabetes mellitus at Reunion Island (France). Gynecol Obstet Fertil. 2007;35(6):530–5.PubMedCrossRef

18.

Kale SD, Kulkarni SR, Lubree HG, et al. Characteristics of gestational diabetic mothers and their babies in an Indian diabetes clinic. J Assoc Physicians India. 2005;53:857–63.PubMed

19.

Boriboonhirunsarn D, Talungjit P, Sunsaneevithayakul P, et al. Adverse pregnancy outcomes in gestational diabetes mellitus. J Med Assoc Thai. 2006;89(Suppl 4):S23–8.PubMed

20.

Xiong X, Saunders LD, Wang FL, et al. Gestational diabetes mellitus: prevalence, risk factors, maternal and infant outcomes. Int J Gynaecol Obstet. 2001;75(3):221–8.PubMedCrossRef

21.

Van W, Wootten BS, Turner RE. The prevalence of macrosomia in neonates of gestational diabetic mothers analysis of risk factors. J Am Diet Assoc. 1999;99(9):A32.

22.

Magee MS, Walden CE, Benedetti TJ, et al. Influence of diagnostic criteria on the incidence of gestational diabetes and perinatal mortality. J Am Med Assoc. 1993;269(5):609–15.CrossRef

Title: Outcome of Gestational Diabetes Mellitus from a Tertiary Referral Center in South India: A Case–Control Study
Authors: Mamta Bhat
K. N. Ramesha
Sankara P. Sarma
Sangeetha Menon
S. Ganesh Kumar
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: The Journal of Obstetrics and Gynecology of India / Issue 6/2012
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI: https://doi.org/10.1007/s13224-012-0226-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome of Gestational Diabetes Mellitus from a Tertiary Referral Center in South India: A Case–Control Study

Abstract

Background

Study Design

Materials and Methods

Statistical Analysis

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Study Design

Materials and Methods

Statistical Analysis

Results

Conclusions

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