Maternal and Neonatal Outcomes of Gestational Diabetes

Presentation Number: SAT 592
Date of Presentation: April 1st, 2017

Huguette Stephanie Brink*1, Marije Alkemade2, Aart J. van der Lely3 and Joke Van der Linden4
1Maasstad hospital, Rotterdam, Netherlands, 2Maasstad hospital, 3079 DZ, Netherlands, 3Erasmus University Medical Center, Rotterdam, Netherlands, 4Maasstad hospital, Rotterdam, NETHERLANDS

Abstract

Aims: To analyse maternal and neonatal outcomes of gestational diabetes (GD) and identify factors associated with neonatal complications.

Methods: A retrospective analysis of singleton GD pregnancies between 2010-2015 in a large cohort in Rotterdam, the Netherlands. Outcomes were compared to a control group (CG; no GD, type 1 or 2 diabetes mellitus) from the Netherlands Perinatal Registry.

Results: 1008 consecutive singleton pregnancies with GD were analysed, N=389 (38.7%) of women required additional insulin therapy. Compared to CG (N= 574.823), the rates of pre-eclampsia (3.8% vs. 5.1%), large for gestational age (>P90) (8.5% vs. 10.7%) and pre-term birth (6.6% vs.8.1%) were not significantly different. The rate of labour induction was higher compared to the CG (56% vs. 29.2%). Neonatal complications defined as a composite neonatal outcome including: death (perinatal/neonatal), large for gestational age (>P90), APGAR < 7 at 5 minutes, pre-term birth (< 37 weeks), neonatal hypoglycaemia (< 2.6 mmol/L), admission to neonatology department, hyperbilirubinemia requiring phototherapy or birth trauma (shoulder dystocia, brachial plexus injury, bone fracture (humerus/clavicle) occurred in N= 348 (34,5%). Independent risk factors predicting the composite neonatal outcome were body mass index (kg/m²) > 30 (OR 1.5 [1.00-2.1] p=0.046) and insulin therapy (OR 1.5 [1.0-2.2] p=0.026).

Conclusions: Adverse maternal and neonatal outcomes in GD, are comparable to normoglycaemic pregnancies. However, obesity and insulin therapy are predictive of an increased risk of neonatal complications. This study underlines the importance of weight control before pregnancy. Health care professionals should play an important role in prevention of obesity in young women.

 

Nothing to Disclose: HSB, MA, AJV, JV