Endocrine Abstracts

Introduction: Pregnancy in women with diabetes is considered high risk because of potentially serious maternal and fetal complications that can put in to risk the maternal and fetal prognosis.

Objective: Describe and analyze risks associated with diabetic pregnancies and compare maternal fetal prognosis of pregnancies with pregestational diabetes (T1D and T2D) with gestational diabetes mellitus (GDM).

Patients and methods: It was a descriptive retrospective study including 293 diabetic pregnant women, hospitalized in Endocrinology and Diabetology department of Ibn Rochd University Hospital of Casablanca, over a period from January 2013 to December 2016. Data collection was done from medical records. The statistical analysis was done by SPSS.

Results: The middle-aged of patients was 31.6-year-old, 50.5% had T2D, 24.5% T1D and 25.5% had GDM. 38% of patients had a history of miscarriage, 20.3% fetal death in utero (FDIU) and 38% had macrosomia. Regarding maternal complications: 41.5% of patients delivered by Caesarean section which 30.6% had pregestational diabetes and 9.6% had GDM (p: 0.02), the threat of premature birth was 22%, 15% for preeclampsia, Urinary tract infection was significantly associated with patients with GDM (P<0.001) in the order of 22%. For fetal complications: 33% had macrosomia, 14.2%, neonatal jaundice, 9.5% were premature, polyhydramnios has been objectified in 13%, the FDIU in 16.2% of patients, neonatal mortality was of the order of 5.9%, 1.8% had shoulder dystocia and 6.3% of new borns were transferred to intensive care. Only macrosomia and shoulder dystocia were significantly associated with patients with GDM compared to those with pregestational diabetes (p: 0.008 and p: 0.001).

Discussion: We see a high rate of complications in diabetic pregnancies without prior followed with a high rate of miscarriages, fetal death, shoulder dystocia, and macrosomia, more frequent in cases of GDM.