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Neonatal outcome in pregnancies complicated by gestational diabetes mellitus

Background. Gestational diabetes mellitus (GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. Diagnose is obtained by 75g/2h oral glucose tolerance test. GDM poses a risk for mother and child, related to high blood glucose levels and its consequences. The main risks GDM imposes on the baby are growth abnormalities, linked to higher rate of Caesarean section (SC) and delivery trauma, and chemical imbalances after birth. Objective. To determine the impact of gestational diabetes on neonatal complications compared to healthy pregnancies. Study design. We retrospectively analyzed GDM pregnancies from 10-year period, delivered in our hospital, and compared the data to similar number of healthy pregnancies (Control group, C). A total of 3396 newborns from singleton pregnancies were enrolled in the study. Analyzed variables in newborns were: preterm birth, SC, birth weight, neonatal macrosomia (≥4000 g), perinatal asphyxia, transitory hypoglycaemia, transitory tachypnoea, RDS, perinatal infection, hyperbilirubinaemia, cephalhaematoma, clavicular fracture, brachial plexus paresis, and congenital malformations. Results. The statistically significant difference was found in following variables: preterm birth (GDM 14.5%, C 6.87%, p<0.001), rate of SC (GDM 36.9%, C 16.8%, p<0.001), birth weight (GDM 3500±699g, C 3362±762g, p<0.001), neonatal macrosomia (≥4000 g) (GDM 23.8%, C 15.4%, p<0.001), perinatal asphyxia (GDM 5.5%, C 1.8%, p<0.001), transitory hypoglycaemia (GDM 3.5%, C 0.3%, p<0.001), RDS (GDM 1.0%, C 0.4%, p=0.024), hyperbilirubinaemia (GDM 17.3%, C 12.0%, p<0.001), and congenital malformations in total (GDM 4.2%, C 2.8%, p=0.032). The following variables: transitory tachypnoea, perinatal infection, cephalhaematoma, clavicular fracture, and brachial plexus paresis, did not differ significantly between groups. Conclusion. GDM does not only bear higher risk for neonatal complications linked to advanced baby growth and chemical imbalances, but also for preterm birth, perinatal asphyxia, RDS and congenital malformations. No significant difference between the groups regarding birth trauma is probably due to higher rate of SC in GDM group. With firmer blood

neonatal outcome; pregnancy; gestational diabetes mellitus

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