Pregnancy Outcomes in Gestational Diabetes Mellitus Diagnosed before 24 Weeks Gestational Age

Abstract

Pregnancy Outcomes in Gestational Diabetes Mellitus Diagnosed before 24 Weeks Gestational Age

Putthawan Tekasakul MD

Department of Obstetrics and Gynecology, Taksin Hospital, Bangkok Metropolitan Admistration (BMA)

Objective: To determine the pregnancy outcomes in gestational diabetes mellitus (GDM) diagnosed during pregnancy and before 24 weeks of gestation.

Methods: This was retrospective descriptive study. Hospital records of women with gestational diabetes mellitus diagnosed during pregnancy and before 24 weeks of gestation who delivered at Taksin Hospital, BMA during October 1, 2004 to September 30, 2009 were reviewed. Maternal baseline characteristics and obstetrical data including: pregnancy outcomes of the mother and fetus as well as complications were collected and analyzed.

Results: The mean age of 227 pregnant women included in this study was 33.0 + 5.2 years. Mean gestational age at diagnosis was 17.0 + 4.2 weeks. There was 161 women (70.9%) diagnosed as GDM A1 and 66 women (29.1%) diagnosed as GDM A2. Out of 227 women, 52 cases (22.9%) were treated with insulin while the remaining had diet control. Except two women, all other 225 cases (99.1%) obtained good blood glucose control during pregnancy. Pregnancy induced hypertension was also identified in 3 cases (1.3%). Preterm delivery occurred in 18 cases (7.9%) while 96 cases (42.3%) had delivery by cesarean section. Postpartum hemorrhage was encountered in 3 cases (1.3%). Regarding the new born infants, the mean birth weight was 3,110.1 + 551.0 g. Fetal death or stillbirth were encountered in 4 cases (1.8%) while 6 (2.6%) had birth asphyxia or APGAR score at 5 minutes less than 7. Neonatal hypoglycemia was found in 5 cases (2.2%).

Conclusion: Except for a rather high rate of cesarean section, gestational diabetes mellitus diagnosed before 24 weeks of gestation had fair pregnancy outcomes with only a few events of other maternal and fetal complications.

Keywords: gestational diabetes mellitus (GDM), pregnancy outcomes, early diagnosis