Gestational Diabetes Mellitus at Maharat Nakhon Ratchasima Hospital
Main Article Content
Abstract
Objective: To access the prevalence of gestational diabetes mellitus (GDM) in pregnant women, to evaluate risk factors of GDM and to compare the pregnancy outcome between GDM class A1 and A2. Patients & Methods: Retrospective descriptive study at Department of Obstetrics and Gynecology, Maharat Nakhon Ratchasima Hospital was performed. Pregnant women who were diagnosed with GDM and who received treatment following clinical practice guideline at Maharat Nakhon Ratchasima Hospital from September 2004 to October 2007 were enrolled. Data were abstracted from outpatient and inpatient medical record regarding risk factors of GDM and pregnancy outcome of both the mothers and their infants, and then were collected for further statistical analysis. Results: There were totally 24,915 pregnancies into the study. One hundred and fifty-one cases of GDM were detected with the prevalence of 0.61%. The most common clinical risk for GDM was obesity (112 cases, 74.2 %). Sixty-eight cases (45%) were GDM class A1 and 87 cases (55%) were GDM class A2. Premature rupture of membrane was the most common maternal complications (36 cases, 23.8%). The most common neonatal complications were hypoglycemia (27 cases, 17.9%). Cesarean section was the most common mode of delivery (103 cases, 68.2%). Thirty-three cases (21.9%) were preterm birth. When GDM of different class were compared, mode of delivery, maternal complications and neonatal complications were not statistically different. Conclusion: The prevalence of GDM at Maharat Nakhon Ratchasima Hospital was 0.61%. The most common risk factors of GDM were obesity, maternal age > 35 years and chronic hypertension or gestation hypertension. There were no significant differences in mode of delivery and any maternal and neonatal complications between GDM class A1 and A2.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
No author. Diabetes. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC III, Hauth JC, Wenstrom KD. Williams Obstetrics. 21st ed. New York: McGraw-Hill; 2001. p. 1359-82.
Adams KM, Li H, Nelson RL, Ogburn PL Jr, Danilenko-Dixon DR. Sequelae of unrecognized gestational diabetes. Am J Obstet Gynecol 1998; 178: 1321-32.
Bartha JL, Martinez-Del-Fresno P, Comino-Delgado R. Gestational diabetese mellitus diagnosed during early pregnancy. Am J Obstet Gynecol 2000; 182: 346-50.
Kjos SL, Buchanan TA. Gestational diabetese mellitus. N Engl J Med 1999; 341: 1749-56.
Casey BM, Lucas MJ, Mcintire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol 1997; 90: 869 -73.
O’Sullivan JB. Diabetes mellitus after GDM. Diabetes 1991; 40 (Suppl 2): 131-5.
American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin. Clinical management guidelines for obstetricians-gynecologists. Number 30, September, 2001. Gestational diabetes. Obstet Gynecol 2001; 98: 525-38.
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2000; 23 (Suppl l): S4-19.
Snidvonges W, Auamkul S, Manotai P. Screening test of gestational diabetese mellitus: a clinical experience. Chula Med J 1988; 32: 5-16.
Serirat S, Deerochanawong C, Sunthornthepvarakul T, Jinayon P. Gestational diabetes mellitus. J Med Assoc Thai 1992; 75: 315-9.
Chanprapaph P, Sutjarit C. Prevalence of gestational diabetes mellitus (GDM) in women screened by glucose challenge test (GCT) at Maharaj Nakhon Chiang Mai Hospital. J Med Assoc Thai 2004; 87: 1141-6.
Boriboonhirunsarn D, Talungjit P, Sunsaneevitayakul P, Sirisomboon R. Adverse pregnancy outcomes in gestational diabetes mellitus. J Med Assoc Thai 2006; 89 (Suppl 4): S23-8.
Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract 2005; 69: 276-86.
El Mallah KO, Narchi H, Kulaylat NA, Shaban MS. Gestational and pre-gestational diabetes: comparison of maternal and fetal characteristics and outcome. Int J Gynecol Obstet 1997; 58: 203-9.
Taylor R, Lee C, Kyne-Grzebalski D, Marshall SM, Davison JM. Clinical outcomes of pregnancy in women with type 1 diabetes. Obstet Gynecol 2002; 99: 537-41.
Sugaya A, Sugiyama T, Nagata M, Toyoda N. Comparison of the validity of the criteria for gestational diabetes mellitus by WHO and by the Japan Society of Obstetrics and Gynecology by the outcomes of pregnancy. Diabetes Res Clin Pract 2000; 50: 57–63.
Pennison EH, Egerman RS. Perinatal outcomes in gestational diabetes: a comparison of criteria for diagnosis. Am J Obstet Gynecol 2001; 184: 1118-21.
Griffin ME, Coffey M, Johnson H, Scanlon P, Foley M, Stronge J, et al. Universal vs. risk factor-based screening for gestational diabetes mellitus: detection rates, gestation at diagnosis and outcome. Diabet Med 2000; 17: 26-32