Maternal and neonatal outcomes in patien ts with gestational diabetes mellitus in Na

resuan University Hospital

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OutlineOutline

BackgoundObjectiveMaterials and MethodsResults and DiscussionConclusions

BACKGROUNDBACKGROUND

BackgroundBackground

Gestational diabetes mellitus is carbohydrate intoleran ce with onset or first recognition during pregnancy.

- About 1 14 percent of pregnancy develops this conditi on depend on the nation2

In thailand, from faculty of medicine, Mahidol Universit

-y in 2550 found that the incidence of GDM about 2 3%

BackgroundBackground GDM is linked to several maternal and fetal complications and h

as morbidity and mortality. -58

GDM is one of the most common pregnancy complications that affects as many as 5% of all pregnancy women.9

Maternal complications : Increase rate of cesarean section, Post partum hemorrhage, Pregnancy induced hypertension, Preterm

labor, Polyhydramnios. -58

Fetal complications - - : Macrosomia, Large for gestational age (LG A), Respiratory distress syndrome, Hypoglycemia, Hyperbilirubi

nemia, Polycythemia, Low APGAR score. -58

BackgroundBackground

GDM frequently resolves after delivery but 1/3 cases wil - lhavediabetesorimpairedglucosemet abol i smat post par t umscr eeni ng and 15 50% w

ill develop diabetes in the decades following the pregna ncy making it one of the most common health problems

inpr egnancy.

Therefore, t he dat a col l ect i on on t he pr egnancy out comes i n Naresuan University Hospital should be made

OBJECTIVEOBJECTIVE

Objective

To determine maternal and neonatal outcomes in pati

ents with GDM in Naresuan University Hospital compa

- ring with non diabetic pregnancy clients.

MATERIALS AND MATERIALS AND METHODSMETHODS

Materials and Methods Ret r ospect i ve cr oss sect i onal st udy

GDM pregn ancy woman

Pregnancy outcome

Data collecting From medical records regarding baseline characte

ristics, maternal and neonatal outcomes, route of de livery, glycemic control and diabetic management.

General characteristics

Maternal

Fetal

Fetal

Maternal

Materials and Methods

Study population Subject group

Inclusion criteria

GDM who delivered at Naresuan University Hospital du ring June 1, 1999, to May 31, 2012

Exclusion criteria Over t DM

Materials and Methods

Control group Inclusion criteria

- Non diabetic women who delivered during June 1, 1 999, to May 31, 2012 by using Systematic Random

Sampl i ng Exclusion criteria

History of DM, GDM, congenital anomalies relate d t o DM

RESULTS AND RESULTS ANDDISCUSSIONDISCUSSION

1Figure . Demographic comparison of patient with G DM

and a cont r ol gr oup wi t hout GDMDemographic GDM

59(n= )Control59(n= )

n % n %

Age [mean ± SD] [year] 3342 577. ± . 274 640. ± .

< 2 0 2 339. 12 2034.

-2029 12 2032. 23 3898 29> 45 7623. 24 4066.

- nn nnn nnn n [ ± SD] [kg/m2 ]

2349. ±448. 2093. ±358.

185< . 7 1186. 15 2542.

-185229. . 23 3898. 32 5424.

229> . 29 4915. 12 2034.

Figure 2 . Comparison ofmaternal outcomes in patients wi thGDManda control groupwi thout GDM

★

★

★ Significant

GHTPrematurecontraction

primary C/S

PPH (Tear)

★

24 cases406.8%

11 cases186.4%

9 cases152.5%

16

3.Figure Comparison of fetal outcomes in patients wit h GDM and a control group without GDM

★

★ Significant

★

★

21 cases354.9%

17 cases288

1% 12 ca

ses203.4%

4Figure . Maternal and fetal outcome among women wnnn nnn nnnn nnnnnnnnnn nnn nnnnnn nnnnnnnnnn nnn

LGA Hypoglycemia

LOS

CONCLUSIONSCONCLUSIONS

Conclusion

Maternal andfet al outcome

GDM Pregnancy

Well control

Treatment

Poor control

-Preterm

-Macrosomia

-Hypoglycemia

Neonatal

- Hypogl ycemi a

- LGA

- NICU

Maternal

- Primary C/S

-Preterm

- GHT

References 1 . National Diabetes Data Group Classification and diagnosis of di

abetes mellitus and other categories of glucose intolerance Diabet -es 1979; 28: 1039 57. 2 . Hadden DR Geogrphic, ethnic, and racial variations in the incid

198534 2ence of gestational diabetes mellitus Diabetes ; (suppl ):- 812

3. Hunt KJ,Schuller KL. The increasing prevalence of diabetes in pr -egnancy. Obstet Gynecol Clin North Am 2007; 34:173 99,vii

4. Serirt S, Derrochanawong C, Sunthornthepvarakul T, Jinayon P G -estational diabetes mellitus J Med Assoc Thai 1992; 75: 315 8.

5. Cunnungham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III, W 22enstrom KD, Diabetes. Williams Obstetrics. nd ed. New York: McG

- -2005116984raw Hill; :

Thank you for Thank you for your attentionyour attention