Abstract
Objectives: The aim of this study was to compare the maternal and the perinatal outcomes of women with PreGestational Diabetes Mellitus (PGDM) with the outcomes of those with Gestational Diabetes Mellitus (GDM).
Methods: In a retrospective cohort study the maternal and the neonatal outcomes of women with PGDM, were compared to the outcomes of women with GDM. Data were collected for the period of 12 months, from the 1st of January to the 31st of December 2012, from the labour ward registry. Data compared were; age, parity, mode of delivery, premature delivery, previous history of miscarriage, birth weight, macrosomia, rate of APGAR scores less than 7 at 5 minutes and stillbirth rate. Student t test was used to compare continuous variables and Chi squared was used to compare categorical variables. Multivariate analysis was used to estimate adjusted Odds Ratio (OR).
Results: Of the 3413 deliveries during the study period, 3157 fulfilled the inclusion criteria; of those there were a total of 685 deliveries for diabetic women. 569 (83.1%) had GDM and 116 (16.9%) had PGDM. Of those with PGDM, 66 (57%) had T1DM and 50 (43%) had T2DM.
Compared to the GDM group, women with PGDM were more likely to be delivered by caesarean section (CS), adjusted OR 2.6, 95% CI (1.66-4.09). The neonates of mothers with PGDM were significantly heavier compared to those of GDM group, p<0.001; and the frequency of macrosomia was more, adjusted OR 3.67, 95% CI (1.75-7.71). Mothers with PGDM have increased risk of preterm delivery less than 37gestations weeks, adjusted OR 2.63, 95% CI (1.49-4.70). There was no statistically significant difference between the two groups in the rate of APGAR scores less than 7 in 5 minutes or the rate of stillbirth.
Conclusion: PGDM is associated with worse pregnancy outcomes compared to GDM.