Gestational Diabetes Mellitus - its Control, Maternal and Perinatal Outcome - A Retrospective Study in Sri Balaji Medical College Hospital, Chennai, Tamil Nadu, India

To compare pregnancy outcomes in women with GDM to those with normal glucose tolerance and to analyze glycemic control in women with GDM and its effect on perinatal outcome. A 75gm OGCT is done in all the women during their first visit to the antenatal clinic. A diet or insulin regimen is initiated according to clinical judgment and OGCT result. To assess the effectiveness of the treatment regimen, she is followed up with regular fasting plasma glucose (FPG) and post prandial plasma glucose (PPPG) values. Treatment is adjusted accordingly. After delivery, perinatal outcome is assessed. Babies are breast fed soon after birth and allowed to stay with the mother until discharge. FPG and PPPG values were monitored antenatally in the diabetic cohort. The median value was calculated for FPG and PPPG. A minimum of 3 glucose samples were required, and subjects were assigned to a group of good control if FPG < 95mg/dl and PPPG < 120mg/dl, and poor control if FPG > 95mg/dl and/or PPPG > 120mg/dl. Induction of labour was similar between the two groups. There was no difference in maternal characteristics between groups that had good and poor control. Good control was not associated with the treatment regimen used. Two hour glucose values at OGCT were not predictive for future control. Neonatal hypoglycemia was significantly associated with poor control. The incidence of macrosomia, neonatal intensive care unit (NICU) admission prior to discharge was similar, irrespective of glucose control. GDM is associated with adverse perinatal outcome. The degree of glycemic control is not predictive of adverse perinatal morbidity and mortality.