Pregnancy outcome of mothers with gestational mellitus in a tertiary care centre; Sri Lanka

Abstract

INTRODUCTION: Reported prevalence of Gestational Diabetes Mellitus (GDM) varies from 0.6% in China to 15% in Indianborn Australians. Evidence is increasing that GDM raises the risk of adverse clinical consequences in the fetus. Good glycaemic control is known to reduce the adverse outcomes. Even though, highly improved outcomes have been reported, reflected by a dramatic decline in maternal and perinatal morbidity and mortality over the past few years, debate persists on the care of pregnant women with GDM. OBJECTIVES: The objectives of this study were to determine the pregnancy outcomes of gestational diabetes mellitus in Sri Lankan population. METHODS: Cohort of pregnancies diagnosed with GDM (n=389) according to WHO criteria were followed up for completion of their pregnancy with 1344 pregnant women registered in the period between 2015 to 2016 in Obstetric unit in Colombo North Teaching Hospital, Sri Lanka. RESULTS: Significant risk of adverse events were observed for macrosomia (RR = 1.32, 95% CI 1.24 - 2.22; p<0.002), large for gestational age (RR = 1.54; 95% CI 1.35 - 1.89; p<0.001), preeclampsia (RR = 1.14, 95% CI 1.04 - 1.23; p<0.03), caesarean delivery (RR = 1.15, 95% CI 1.07 - 1.56: p<0.001) and Neonatal Intensive Care Unit (NICU) admissions (RR = 1.12, 95% CI 1.05 - 1.28; p<0.004). Perinatal mortality (RR = 1.57, 95% CI 0.76 - 2.92; p = 0.2) was not significantly associated with GDM. CONCLUSION: Gestational Diabetes should be controlled, in order to reduce both the maternal and neonatal complications, and accordingly reduce the burden on neonatal care.