Endocrine Abstracts

Gestational diabetes mellitus (GDM) is a carbohydrate intolerance with onset or first recognition occurring during pregnancy. GDM could be risk factor for various maternal fetal complications.

Objective: To study newborns’s condition to mothers with GDM and pregnancy outcomes in women with GDM.Patients and methodsObstetric and perinatal outcomes were compared in two mother-child groups. Group I consisted of 69 mothers with uncontrolled GSD and their 71 children, group II – 59 women with controlled GSD and 60 of their children. According to the existing criteria, blood plasma glucose values in pregnant women on an empty stomach/before meals/at night <5.1 mmol/l, and 1 hour after meals <7.0 mmol/l were considered normal.

Results: Mothers with uncontrolled GSD had statistically significant higher rates of pre-obesity and obesity before pregnancy (62.3% and 44.1% accordingly; P<0.05), chronic gynecological diseases (94.2% and 81.4% accordingly; P<0.05), preeclampsia (29.0% and 8.5% accordingly; P<0.001) and the threat of termination of pregnancy (40.6% and 20.3% accordingly; P<0.05) compared to women with controlled GSD. Group 1 newborns were statistically significant more likely to have complications and diseases of the early neonatal period (50.7% and 26.7% accordingly; P<0.001), macrosomia (25.4% and 11.7% accordingly; P<0.05), neonatal jaundice (12.7% and 1.7% accordingly; P<0.05), cerebral ischemia (46.5% and 23.3% accordingly; P<0.001), birth trauma (14.1% and 3.3% accordingly; P<0.05). Only children of group I had congenital malformations in 16.9% of cases. The incidence of diabetic fetopathy in group I newborns was almost 2 times higher, but without significant differences (12.7% and 6.7% accordingly, p>0.05). The presence of macrosomia and diabetic fetopathy in group II newborns may be associated with late diagnosis of GSD (after 30 weeks of gestation).

Conclusion: A significantly higher frequency of adverse perinatal outcomes in newborns, as well as obesity, gynecological diseases and pregnancy complications in women with uncontrolled GSD compared to mothers with controlled GSD and their children was established. To normalize glycemic parameters in pregnant women with GDM and improve obstetric and perinatal outcomes, it is necessary to promptly prescribe rational insulin treatment schemes, if diet therapy is ineffective, and improve the quality of patient follow-up.