Maternal and neonatal outcomes of gestational diabetes: A retrospective cohort study from Southern India

P R Sreelakshmi, Sanjeev Nair, Biju Soman, Rani Alex, K Vijayakumar, V Raman Kutty, P R Sreelakshmi, Sanjeev Nair, Biju Soman, Rani Alex, K Vijayakumar, V Raman Kutty

Abstract

Background: The prevalence of gestational diabetes is on the rise. Understanding the various outcomes of it is necessary to face this challenge.

Objectives: To study the frequency of occurrence of various maternal and fetal outcomes among gestational diabetes patients.

Methods: This is a retrospective cohort study conducted in rural Kerala, a southern state of India. The study participants were followed up for a period of 4 years, from 2007 to 2011. The participants included 60 women with gestational diabetes and 120 women without gestational diabetes. Gestational diabetes was the major exposure variable. The frequencies of various outcomes were computed. Multivariable logistic regression was done to compute the risk for various outcomes in gestational diabetes.

Results: The major outcomes included termination of pregnancy by caesarean section, long-term progression to type 2 diabetes, in-born nursery (IBN) admissions and increased neonatal birth weight. The maximum adjusted RR [13.2 (1.5-116.03)] was for the development of type 2 DM later.

Conclusion: Gestational diabetes can result in significant feto-maternal outcomes; so better facilities are needed to manage gestational diabetes.

Keywords: Gestational diabetes; pregnancy outcome; retrospective cohorts.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Geneva: World Health Organization; 2013. [Last Accessed on 2014 Sep 18]. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Published 2013. Available from: .
    1. Ferrara A. Increasing prevalence of gestational diabetes mellitus. A public health perspective. Diabetes Care. 2007;30:141–6S.
    1. Anna V, Van Der Ploeg HP, Cheung NW, Huxley RR, Bauman AE. Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between 1995 and 2005. Diabetes Care. 2008;31:2288–93.
    1. Schmidt MI, Duncan BB, Reichelt AJ, Branchtein L, Matos MC, Costa e Forti A, et al. For the Brazilian Gestational Diabetes Study Group. Gestational diabetes mellitus diagnosed with a 2-h 75 gm oral glucose tolerance test and adverse pregnancy outcomes. Diabetes Care. 2001;24:1151–5.
    1. Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707–11.
    1. 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;66:139–45.
    1. 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;56:329–3.
    1. Harrison C, Bayram C, Britt H. Gestational diabetes. Aust Fam Physician. 2013;42:523.
    1. Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes mellitus and associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res. 2013;137:728–33.
    1. Nayak PK, Mitra S, Sahoo JP, Daniel M, Mathew A, Padma A. Feto-maternal outcomes in women with and without gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Diabetes Metab Syndr. 2013;7:206–9.
    1. Mahalakshmi MM, Bhavadharini B, Kumar M, Anjana RM, Shah SS, Bridgette A, et al. 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;18:400–6.
    1. India: National Family Health Survey; [Last accessed on 2014 Sep 18]. Key indicators of Kerala from NFHS-3. NFHS-3 fact sheets for key indicators based on final data. Available from: .
    1. Bhat M, K N R, Sarma SP, Menon S, C V S, S GK. Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in south India. Int J Diabetes Dev Ctries. 2010;30:91–6.
    1. Kale SD, Kulkarni SR, Lubree HG, Meenakumari K, Deshpande VU, Rege SS, et al. Characteristics of gestational diabetic mothers and their babies in an Indian diabetes clinic. J Assoc Physicians India. 2005;53:857–63.
    1. Albareda M, Caballero A, Badell G, Piquer S, Ortiz A, de Leiva A, et al. Diabetes and abnormal glucose tolerance in women with previous gestational diabetes. Diabetes Care. 2003;26:1199–205.
    1. Baruah MP, Pathak A, Kalra S, Das AK, Zargar AH, Bajaj S, et al. A revisit to prevailing care and challenges of managing diabetes in India: Focus on regional disparities. Indian J Endocrinol Metab. 2014;18:254–63.
    1. Huopio H, Hakkarainen H, Pääkkönen M, Kuulasmaa T, Voutilainen R, Heinonen S, et al. Long-Term changes in glucose metabolism after gestational diabetes: A double cohort study. BMC Pregnancy Childbirth. 2014;14:296.
    1. Hayes C. Long-term prognostic factors in the diagnosis of gestational diabetes. Br J Nurs. 2009;18:523–4. 526.
    1. Samuel R, Ramanathan K, Mathews JE, Seshadri MS. Back to the future: Examining type 2 diabetic vasculature using the gestational diabetic placenta. Diab Vasc Dis Res. 2014;11:363–5.
    1. Daivadanam M, Absetz P, Sathish T, Thankappan KR, Fisher EB, Philip NE, et al. Lifestyle change in Kerala, India: Needs assessment and planning for a community-baseddiabetes prevention trial. BMC Public Health. 2013;13:95.
    1. Kumar GA. Antenatal history and caesarean section in the southern part of Kerala, India. World Health Popul. 2006;8:41–6.
    1. Mishra US, Ramanathan M. Delivery-related complications and determinants of caesarean section rates in India. Health Policy Plan. 2002;17:90–8.
    1. Ovesen P, Jensen D, Damm P, Rasmussen S, Kesmodel US. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes. A nation-wide study. J Matern Fetal Neonatal Med. 2014;1:14.
    1. Maternal and child mortality rates and total fertility rates. [Last accessed on 2014 Sep 20]. Available from: .

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi