Publication:

Maternal and neonatal outcome in gestational and pregestational diabetes

Background Diabetes during pregnancy increases risks for both mother and baby, despite medical advances. This study evaluates and compares maternal and fetal outcomes in pre-gestational and gestational diabetes. The aim of the study was to evaluate the maternal and perinatal outcomes in patients with gestational and pre-gestational diabetes.

Methods This prospective cross-sectional study was conducted at the department of obstetrics and gynecology, BSMMU, and BIRDEM, Dhaka, Bangladesh, from January 2004 to December 2005, involving 150 pregnant women divided into three groups: 50 non-diabetics, 50 with pre-existing diabetes (PDM), and 50 with gestational diabetes (GDM). Data were collected using a structured questionnaire and analysed with SPSS, applying Chi-square and t-tests.

Results Maternal age and weight were similar across groups (p>0.10). Diabetic patients had significantly more pregnancy complications (66-68%) than non-diabetics (28%) (p<0.05), with higher insulin use in pre-gestational diabetes (90%) (p<0.01). Operative deliveries and post-partum issues were more common in diabetics, though not statistically significant. Pregnancy losses were higher in diabetic groups (14% and 6%) vs. none in non-diabetics (p<0.05). Neonatal resuscitation (65.1%, 59.6%) and morbidities (50%, 38%) were also more frequent in diabetics than in non-diabetics (42% and 20%) (p<0.05).

Conclusions Well-controlled diabetes, whether pre-gestational or gestational, still poses increased maternal and perinatal risks compared to non-diabetic pregnancies, but with proper preconception management, favourable outcomes are achievable.