Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) represents one of the most common complications during pregnancy, being associated with numerous maternal and neonatal complications. The study aimed to analyze maternal and neonatal complications associated with GDM. The risk factors of GDM and of the maternal and neonatal complications were studied in order to prevent their occurrence. Materials and Methods: The study included 97 women in the study, who underwent an oral glucose tolerance test (OGTT) between weeks 24–28 of pregnancy, consequently being divided into two groups: pregnant women with and without GDM. Statistical analysis was performed using the SPSS 26.0 software and MATLAB fitglm, the results being considered statistically significant if p < 0.05. Results: We observed statistically significant differences between the group of women with and without GDM, regarding gestational hypertension (17.6% vs. 0%), preeclampsia (13.72% vs. 0%), and cesarean delivery (96.1% vs. 78,3%). Data on the newborn and neonatal complications: statistically significant differences were recorded between the two groups (GDM vs. no GDM) regarding the average weight at birth (3339.41 ± 658.12 g vs. 3122.83 ± 173.67 g), presence of large for gestational age (21.6% vs. 0%), macrosomia (13.7% vs. 0%), excessive fetal growth (35.3% vs. 0%), respiratory distress (31.4% vs. 0%), hospitalization for at least 24 h in the Neonatal Intensive Care Unit (9.80% vs. 0%), and APGAR score <7 both 1 and 5 min following birth (7.8% vs. 0%). Additionally, the frequency of neonatal hypoglycemia and hyperbilirubinemia was higher among newborns from mothers with GDM. Conclusions: The screening and diagnosis of GDM is vital, and appropriate management is required for the prevention of maternal and neonatal complications associated with GDM. It is also important to know the risk factors for GDM and attempt to prevent their appearance.
Highlights
According to the American Diabetes Association (ADA), gestational diabetes mellitus (GDM) is defined as “a previously unknown diabetes, diagnosed during the second or third pregnancy trimester” [1]
In order to exclude overt diabetes, at the first prenatal visit of the pregnant women, we performed fasting blood glucose and we confirmed the diagnosis of diabetes mellitus when the blood glucose was repeatedly ≥126 mg/dL; we did not use for diagnosis the value of HbA1c ≥6.5%, knowing that possible errors can occur during pregnancy [9]
An increasing number of studies show that there are no significant differences between the incidence of GDM cases detected by the two methods: “the one step” approach with 75 g oral glucose tolerance (OGTT) (The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations, based on HAPO study) and “the two step” approach with 50 g nonfasting glucose screening, followed by 100 g oral glucose tolerance test (OGTT) for the patients who screen positive; in addition, the one-step approach is easier for patients to accept and less expansive [10]
Summary
According to the American Diabetes Association (ADA), gestational diabetes mellitus (GDM) is defined as “a previously unknown diabetes, diagnosed during the second or third pregnancy trimester” [1]. Pregnant women with GDM have a higher risk of giving birth to large children for gestational age (LGA—a birth weight ≥ than the 90th percentile for a given gestational age or ±2 SD from the normal average for gestational age, sex, and race) [3]. Data on the newborn and neonatal complications: statistically significant differences were recorded between the two groups (GDM vs no GDM) regarding the average weight at birth (3339.41 ± 658.12 g vs 3122.83 ± 173.67 g), presence of large for gestational age (21.6% vs 0%), macrosomia (13.7% vs 0%), excessive fetal growth (35.3% vs 0%), respiratory distress (31.4% vs 0%), hospitalization for at least 24 h in the Neonatal Intensive Care Unit (9.80% vs 0%), and APGAR score
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