Maternal and Fetal Outcomes of Pregnancy with Controlled andUncontrolled Gestational Diabetes Mellitus of 34 Weeks and Above

Abstract

Background: Gestational diabetes mellitus (GDM) is a common disorder affecting around 7.0% of pregnancies each year. The incidence can be significantly higher in certain minority populations that have an increased predisposition to diabetes. Objective: To evaluate maternal and fetal outcomes in pregnancies at 34 weeks or later with controlled versus uncontrolled gestational diabetes mellitus. Methods: This prospective study was conducted in the Department of Obstetrics and Gynaecology at Shaheed Suhrawardy Medical College & Hospital (ShSMCH), Dhaka, from July 2023 to June 2024. A total of 100 women were enrolled, including 50 with controlled GDM and 50 with uncontrolled GDM. Participants were classified into uncontrolled (Group I) and controlled (Group II) GDM cases. Socio-demographic data included age, parity, gestational age, and socio-economic status, while clinical data comprised height, weight, BMI, blood pressure, fetal presentation, and mode of delivery. Statistical analyses were performed using SPSS-22 software. Result: Multivariate reveals that uncontrolled GDM significantly increases the risk of adverse maternal outcomes. Uncontrolled GDM is associated with higher odds of lower segment cesarean section (LSCS), intrapartum hemorrhage, and postpartum hemorrhage. No significant association is found for urinary tract or wound infections. Regarding fetal outcomes, newborns of mothers with uncontrolled GDM are more likely to require admission to the neonatal intensive care unit (NICU) and resuscitation at birth; however, there is no significant association with low birth weight or preterm birth. These findings underscore the risks posed by uncontrolled GDM. Conclusion: This study emphasizes that uncontrolled GDM in pregnancies of 34 weeks and above significantly increases the risks of cesarean sections, hemorrhages, and neonatal complications like NICU admission and resuscitation, underscoring the need for proper GDM management.

Journal of Dentistry and Allied Science, Vol. 9 No 1: 14-23