Publication:

Maternal and fetal outcomes in diabetes mellitus in hospitalized women at a tertiary care institute in South India

Background Objectives of current study were to find out the proportion of types of diabetes and to know the factors for adverse maternal and fetal outcome in pre-gestational diabetes and gestational diabetes at a tertiary care Institute and to compare the outcomes between pre-gestational diabetes and GDM.

Methods Prospective descriptive study conducted in the department of obstetrics and gynaecology, at a tertiary care center over a period of 1 year. The inclusion criteria were: pre-gestational diabetes (pregnant women with type 1 & type 2 diabetes mellitus) and gestational diabetes mellitus. Exclusion criteria were steroid induced diabetes, tuberculosis, heart disease, autoimmune disorder, chronic renal failure. Statistical analysis: Maternal & fetal outcomes, presence of complications were expressed as proportions and comparison between the 2 groups is done using Chi-square test.

Results Majority of the women (81.5%) were GDM and 18.5% were pre-gestational diabetics (type I DM-5% and Type II-13.5% of total). Past history of GDM was present in 29% of GDM and 31% of type II DM. Sixty percent of GDM and 40% of PGDM were primigravidae. Significantly a greater number of women were obese in PGDM than GDM. Blood sugars were uncontrolled in 20% more so in women with PGDM. Pregnancy loss was more in PGDM when compared to GDM (17.5% vs. 9.1%). Statistically significantly more number with PGDM suffered from hypertension and preterm labour.

Conclusions Obesity, uncontrolled blood sugars, development of hypertension and pre-term labour are the significant factors resulting in adverse maternal and fetal outcomes and these are more common in women with PGDM.