Endocrine Abstracts

Whether frequency of complications during pregnancy increases when gestational diabetes (GD) is diagnosed early (<24 weeks) compared to late (>24 w) is not fully define. Observational studies suggest fasting glucose values (>92 mg/dl) during the first trimester are associated with adverse perinatal outcomes.

Objectives: describe the characteristics of pregnant women with GD, the frequency of complications during pregnancy and delivery and assess the differences between early and late diagnosis of GD.

Material and methods: Retrospective study of 70 women with GD diagnosed between 2022 and 2023 in two second level hospitals. We described demographic, anthropometric and clinical data, and compared obstetric-perinatal outcomes according to whether GD was early or late.

Results: Of all women, 64.3% were non-European (North Africa 28.6%, South America 22.9% and Pakistan 10%), mean age of 34±5.74 years. 42.9% had early GD. The reasons for 1st trimester screening were BMI, previous GD and age (42.8%, 31.42% and 28.6%, respectively). The mean BMI of the early GD group was 31.91 kg/m² vs 28.64 kg/m² in the late group (P=0.003) and 1st trimester fasting glucose and O’Sullivan score were higher in the early group (98.93 mg/dl vs 89.88 mg/dl (P=NS) and 197 mg/dl vs 171 mg/dl P<0.001). Insulin was required in 47.1% of the sample, the majority in the early group (18/30 vs 15/40 (P=NS)). Only 5/18 were insulinised in the 1st trimester, 15 in the 2nd and 13 in the 3rd trimester. There were differences in the need for insulin according to origin: 60% of non-European vs 24% of Europeans (P=0.004). Regarding delivery, 8 patients had a preterm birth: 15% on the late group vs 6.6% on the early group (P=NS). Of all new-borns, 9 had neonatal hypoglycaemia, without differences between clusters. Hypoglycaemia was not related to prematurity, macrosomia or small for gestational age (SGA). 37% had complications during pregnancy (P=NS), being pre-eclampsia/HT the most frequent (12.9%). Large for gestational age (LGA) new-borns were higher in the early GD group (26.6% vs 17.5%, P=NS).

Conclusions: - In our setting, early diagnosed GD does not increase the frequency of obstetric complications, although there is a higher rate of LGA new-borns. It would be necessary to assess differences according to the degree of GD control. - Basal glycaemia in first trimester was higher in the early GD cluster. It is necessary to evaluate it as a risk factor for the development of GD.