Gestational diabetes – an obstetric, neonatal and postnatal challenge

Abstract

In recent decades, the demographics of pregnant women have changed, with an increase of women giving birth at an older age and which, associated with the increase of obesity, has led to a rise in the prevalence of gestational diabetes mellitus (GDM). This has become a global concern and, from a public health perspective, it has huge implications for the mother and the baby. This longitudinal and transversal re­tro­spec­tive study was conducted at the Department of Obstetrics and Gynecology of the “Regina Maria” Hospital – Private Health Network, Bucharest, and included 200 preg­nant women who gave birth between 1 July 2021 and 30 June 2022. The patients selected were grouped into two major categories: the study group (100 pregnant wo­men with gestational diabetes), and the control group (100 preg­nant women without gestational diabetes). The total num­ber of births in this period was 3807 (out of which 404 pa­tients had gestational diabetes, representing 10.61%). The women were selected based on the following cri­te­ria: the glucose tolerance test with 75 g of modified glu­cose, with clinical exploration (age, Body Mass Index [BMI], he­re­di­tary antecedents, associated pathology, type of preg­nan­cy), paraclinical and ultrasound. We included in our study pa­tients of different ages and with different BMI. Women who gave birth to twins or more, with pre-preg­nan­cy dia­be­tes or with unavailable or incomplete case data were ex­clu­ded from the study. The data used were collected from the patients’ observation documents, birth and operation re­cords, and from the Medis medical information system. Microsoft Excel was used to analyze the data. The aim of the study is to show that having a normal BMI lowers the risks of gestational diabetes, and that patients with obesity have a higher risk of gestational diabetes. We want to demonstrate that there are direct correlations between clinical and pa­ra­cli­ni­cal changes and maternal and fetal complications for pregnant women with gestational diabetes, and that ha­ving a good glycemic control is of great importance for the amelioration of pregnancy complications and perinatal con­ditions.