Maternal and fetal outcomes in women with undiagnosed gestational diabetes (GDM)

Abstract

The aim: of this study was to evaluate whether undiagnosed and untreated GDM in women with risk factors can influence the outcome of pregnancy. Material and methods: The outcome of 100 pregnancies with risk factors but not diagnosed GDM (I group) was compared with the outcome of 496 women with diagnosed and treated GDM (II group) and with 300 pregnant women with normal glucose tolerance test (III group). The GDM risk factors were family history of diabetes, age = 35 years, overweight, hydramnios and previous macrosomia. GDM was diagnosed using the WHO 75 g glucose tolerance test. Results: The rate of essential hypertension and cesarean section was much higher in the I and II group than in the III group: essential hypertension I – 7%, II – 7,7%, III – 1,3%, cesarean section I – 36%, II – 30,7%, III – 9,3% (p<0,05). The stillbirth rate was significantly higher only in the group of women with the risk factors: I – 4%, II – 1,01%, III – 0,3% (p<0,05). All these stillbirths of the I group occurred in the III trimester of pregnancy, two of them had congenital heart failure. Conclusions: These data suggest, that screening of pregnant women for GDM and treatment can improve the outcome for the fetus and newborn and avoid unexplained stillbirths.