Effect Of Gestational Diabetes Mellitus On Pregnancy Outcome

Objective To determine whether gestational diabetes is an independent predictor of perinatal complications; and to determine whether treatment of women with gestational diabetes mellitus could reduce the risk of perinatal complications.Methods During the study period of 3 years from January 2003 toDecember 2005, one hundred and fifty eight cases with gestational diabetes mellitus (GDM) gravidas were compared with one hundred and fifty eight nondiabetic subjects matched for maternal age(±lyr), exact parity and race during the same period delivered in in our unit. Of the 158 GDM women, 57 women were untreated. Date on maternal and fetal outcomes were collected from medical records.Results 1. The rate of serious perinatal complications was significantlyhigher in the GDM women than that of the nondiabetic women. When adjusting for maternal pre-gestational weight, weight gain from prepregnancy and other confounding factors, women with GDM were at increased risk for preterm birth (8.2 % vs0.6%, p=0.010);macrosomia(12.0% vsl.9%, p=0.000); LGA (24.1% vs 7.6%, p=0.000) and neonatal hypoglycemia (11.4% vs 0.6%, p=0.000). 2. Untreated women also had increased rates of preeclampsia (14.0% vs 1.0%, p=0.002); macrosomia (26.3% vs 4.0%, p=0.000); LGA (24.1% vs 7.6%, p=0.000). There was a significantly higher rate of macrosomia(OR 13.068, 95% CI 3.183 to 53. 650); and LGA (OR 2.243, 95% CI 1. 019 to 4. 935) after controlling confounding factors.Conclusions 1. Gestational diabetes does increase pregnancy risks; 2. Appropriate and effective treatment can reduce serious both maternal and perinatal morbidity and thus improve the outcomes, but it cannot prevent large-for-gestational-age infants.