Pregnancy in Diabetics: Clinicobiological Features and Evolution

Abstract

Background: The association between diabetes and pregnancy is a real public health problem due to the inherent maternal and fetal complications.Aims: To study the clinical and biological features of diabetic pregnancies.Methods: We conducted a retrospective descriptive study including pregnant diabetic women followed at the National Institute of Nutrition of Tunis.Results: We included 100 patients with a mean age of 32.87±5.3 years. In preconception, 63.6% of patients were overweight and had poorly balanced diabetes (HbA1c> 7%). The mean weight gain throughout the pregnancy was 8.62 ± 5.39 kg. Pregnancy was planned in 18% of cases.Significant improvement in HbA1c was observed in the second trimester. The average daily insulin dose increased from 0.68 u/kg/day in the first trimester to 0.87 u/kg/day in the third trimester (p <0.001). Full term delivery occurred in 72% of cases.The majority (93.3%) of our patients gave birth by caesarean section. Macrosomia was observed in 24% of cases. The main neonatal complications were neonatal respiratory distress and hypoglycemia in 26.7% and 20.5% of cases, respectively. Five newborns had deformities.Conclusion: Diabetic pregnancy is associated with an increased risk of maternal and fetal complications. An action on modifiable factors, before conception, could significantly improve its prognosis.