Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul-Aug;20(4):491-6.
doi: 10.4103/2230-8210.183469.

Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)

Manni Mohanraj Mahalakshmi  1 , Balaji Bhavadharini  1 , Kumar Maheswari  1 , Gunasekaran Kalaiyarasi  1 , Ranjit Mohan Anjana  1 , Unnikrishnan Ranjit  1 , Viswanathan Mohan  1 , Kurian Joseph  2 , Kurian Rekha  2 , Sivagnanam Nallaperumal  3 , Belma Malanda  4 , Arivudainambi Kayal  4 , Anne Belton  4 , Ram Uma  5
Affiliations

Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)

Manni Mohanraj Mahalakshmi et al. Indian J Endocrinol Metab. 2016 Jul-Aug.

Abstract

Aim: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC).

Materials and methods: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records.

Results: Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m(2) vs. 25.2 ± 5.1 kg/m(2); P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone.

Conclusion: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings.

Keywords: Asian Indians; South Asians; fetal outcomes; gestational diabetes mellitus; maternal outcomes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Management of gestational diabetes mellitus
See this image and copyright information in PMC

References

    1. Casey BM, Lucas MJ, Mcintire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997;90:869–73. - PubMed
    1. Gabbe SG, Mestman JG, Freeman RK, Anderson GV, Lowensohn RI. Management and outcome of class A diabetes mellitus. Am J Obstet Gynecol. 1977;127:465–9. - PubMed
    1. Fain JR. Gestational diabetes. Diabetes Educ. 1991;17:435. - PubMed
    1. Jones CW. Gestational diabetes and its impact on the neonate. Neonatal Netw. 2001;20:17–23. - PubMed
    1. Jiménez-Moleón JJ, Bueno-Cavanillas A, Luna-del-Castillo Jde D, García-Martín M, Lardelli-Claret P, Gálvez-Vargas R. Impact of different levels of carbohydrate intolerance on neonatal outcomes classically associated with gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol. 2002;102:36–41. - PubMed