Perinatal outcome in diabetic mothers with relation to glycemic control during pregnancy.

Abstract

Objective: To determine the frequency of perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) in pregnant diabetic women with low and high plasma glucose levels between 36-40 weeks. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynaecology, DHQ Hospital, Lodhran. Period: 2017 to 2019. Material & Methods: Total 285 diabetic women of age 25-40 years with singleton pregnancy of gestational age 36-40 weeks were selected. Patients with multiple pregnancies, GDM, renal disease and hypertension were excluded. Plasma glucose levels (fasting & 2 hour post-prandial) measured and mean values (fasting + postprandial/2) calculated. The mean values falling between 100-139 mg/dl were taken as low plasma glucose level where as ≥140 mg/dl noted as high plasma glucose level. The perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) were assessed at the time of delivery. Results: Mean age was 29.44 ± 6.01 years. Mean plasma glucose levels were 109.77 ± 6.81 mg/dl. Perinatal outcome i.e. macrosomia, large for gestational age infants and birth asphyxia was found in 7.72%, 27.37% and 22.81% respectively. In this study that pregnant women with mean plasma glucose of 100-139 mg/dl showed frequency of macrosomia by 3.59%, large for gestational age 16.17% and birth asphyxia 14.35% while women with mean plasma glucose of ≥140 mg/dl showed frequency of macrosomia by 13.56%, large for gestational Age 43.22% and birth asphyxia 34.75%. Conclusion: Pregnant diabetic women with high plasma glucose levels have significantly high percentage of large for gestational age, birth asphyxia and macrosomia as compared to diabetic mothers with low plasma blood glucose levels. Consider diabetic mothers at risk and implement efficacious treatment in order to reduce the perinatal complications.