Outcome of gestational diabetes mellitus from a tertiary referral center in South India: a case-control study

Abstract

Background: Carbohydrate intolerance is the most common metabolic complication of pregnancy. Gestational diabetes mellitus (GDM) poses numerous problems for both mother and fetus. The objective of this study was to compare the maternal and perinatal outcome between women with gestational diabetes mellitus and non-diabetic women.

Study design: A case-control study with 286 cases and 292 age-matched controls was conducted for a period of 11 months (August 2007-June 2008) in Sree Avittom Thirunal Hospital, Thiruvananthapuram, India.

Materials and methods: Universal screening was applied by means of glucose challenge test (GCT) using 50 g of glucose. If GCT >130 mg%, the patients were subjected to oral glucose tolerance test with 100 g of glucose. National Diabetes Data Group criteria was taken to assign patients to study group. These women were further followed up and the maternal and perinatal outcomes were assessed.

Statistical analysis: Univariate analysis was done by means of t test, Odd's ratio, Chi-square test, and Fisher Exact test. P < 0.05 was taken as significant.

Results: The frequency of induction of labor was significantly higher than spontaneous labor (OR = 1.84, P = 0.001). 40.1 % GDM mothers and 35.8 % of non-diabetic mothers were delivered by Cesarean section. Premature rupture of membranes (PROM) was the most common complication of labor (OR = 1.66, P = 0.04). Babies of diabetic mothers had a positive trend toward prematurity (OR = 2.3, P = 0.007). Hypoglycemia was the most common neonatal complication (OR = 11.97, P < 0.001) and nine babies of diabetic mothers were macrosomic (OR = 5.2, P = 0.02).

Conclusions: Maternal morbidities and neonatal complications such as neonatal hypoglycemia, macrosomia, and prematurity were significantly higher in GDM.

Keywords: Chi-square test; Gestational diabetes mellitus; Odd’s ratio; Outcome.

Fig. 1

Distribution of cases and controls