Screening for gestational diabetes mellitus by two step method and the neonatal outcome

Background: As Indian women has increased risk of developing GDM, screening for GDM is essential for early diagnosis and treatment and hence to reduce the adverse neonatal outcomes.Methods: The antenatal women are screened for GDM by administering 50g GCT and the screening test value of >130mg/dl measured at 1 hours were considered screening test positive and subjected to standard 2 hour 75gm OGTT and the neonatal outcome were observed in relation to neonatal birth weight, Apgar, and the occurrence of complications like hypoglycemia, hypocalcemia, hyperbilirubenemia.Results: The average neonatal birth weight in the study population was 3kg. The women with GDM who required diet alone had average neonatal birth weight of 2.9kgs and the GDM women who were on diet and insulin therapy had average neonatal birth weight of 3.4kg. There was increased incidence of hyperbilirubinemia 33.3% .There was only 1 preterm birth.Conclusions: There is association with neonatal Complications like hyperbilirubenemia and hypoglycemia with women who had screening positive for GDM.

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Background: In recent times, gestational diabetes is becoming more common Worldwide and complications are seen in fetal development, growth, labour and delivery due to maternal hyperglycemia. Gestational Diabetes Mellitus(GDM) is associated with adverse maternal and fetal outcomes. Among South Asian Population, Indian Women are at high risk of developing carbohydrate intolerance during pregnancy. Hence this study is undertaken to screen for gestational diabetes mellitus by two step method in Indian Women.Methods: This study was done in 153 nondiabetic pregnant women of gestational age 24-28 weeks, excluding diabetes mellitus diagnosed prior to pregnancy. Two step method was followed in the present study and GDM was diagnosed and the pregnancy outcomes were noted.Results: In our study the prevalence of GDM is 8.1% by two step method. Most of the women diagnosed with GDM were of age 26-30 yrs (41.66%). Among the women who were diagnosed as GDM, (58.33%) cases required Insulin along with diet control. In our study 33.33% had vaginal delivery, 8.33% had Emergency LSCS and 58.33% had Elective LSCS.Conclusion: Indian Women have high prevalence of GDM, hence universal screening is essential to diagnose GDM, which will improve the pregnancy outcome.