Postpartum evaluation of patients with gestational diabetes and newborns characteristics: differences between two periods
Beatriz Mantinan Gil, Reyes Luna Cano, Paula Sanchez Sobrino, Regina Palmeiro Carballeira, Ines Seoane Cruz, Concepción Páramo Fernández & Ricardo Victor García Mayor
Introduction: Blood glucose control during pregnancy is essential in patients with gestational diabetes (GD) to prevent fetal complications. Despite advances in its control, neonatal morbidity and mortality still appears in a significant percentage of cases. The presence of GD also implies consequences for the mother, as the GD appearance in a new pregnancy and/or the future development of glucose metabolism alterations.
Methods: We conducted a retrospective, observational study comparing patients diagnosed of GD in our area in 1999 with those diagnosed in 2008. The variables analyzed were: the required treatment (diet and/or insulin) during gestation, the cesarean rate, newborn (NB) characteristics (weight, neonatal complications and malformation) and mothers postnatal evaluation through oral glucose tolerance test.
Results: We included 384 patients, 131 from 1999 (Group I) and 253 from 2008 (Group II). The treatment required, the type of delivery and postpartum evaluation are summarized in Table 1. The mean weight of the NB was not significantly different between both groups 3208 gr (Group I) versus 3276 gr (Group II). The rate of macrosomy was also similar 6.1% (Group I) versus 5.5% (Group II). One NB of Group I had a cardiac malformation and three cases had malformations (two cardiac and one genitourinary) in Group II. We found two cases of neonatal hypoglycemia, one in each group, and one case of neonatal hyperbilirubinemia in Group II.
Conclusions: We found a significant dercrease in cesarean rate in Group II (18.5%), which is close to the general population rate while in Group I this percentage was still above this general rate (38.3%). A significant number of patients from both groups give up postpartum evaluation. In postpartum evaluated patients, we found a significantly higher impaired oral glucose tolerance rate in Group I. Regarding NB characteristics we did no found differences between both groups.