PREGNANCY OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES: RISK-STRATIFICATION AS A TOOL TO OPTIMISE PERIPARTAL AND POSTPARTUM CARE
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| Year of publication | 2017 |
| Type | Conference abstract |
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| Description | Objectives: Previous studies indicate, that gestational diabetes mellitus (GDM) might be etiopathogenetically diverse metabolic abnormality posing unequal risks and for distinct subgroups of GDM women at the time of delivery and postpartum. We therefore retrospectively classified cohort of GDM women into “high” and “low” risk and conducted case-control study to compare (i) the incidence of peripartal morbidity and (ii) to analyse the potential effect of selected comorbidities (i.e. obesity, hypertension, thyreopathy, polycystic ovary syndrome, trombophylia, anemia, allergy and smoking) on pregnancy outcomes. Methods: Using a cohort of 364 women with GDM following parameters were assessed: ultrasound examination before delivery, gestational week, duration of labour, need for induction, perinatal complications, post-delivery complications, section, abnormity in pH, base excess, Apgar score, offspring’s birth weight. GDM was diagnosed by oGTT test in 24-28th week of gestation. Criteria for “high risk” GDM group were: BMI ?30kg/m2, hypertension in pregnancy, need for insulin therapy, macrosomia, weight gain during pregnancy ?20kg. Results: “High risk” GDM subgroup revealed significantly more frequent labour inductions (P=0.0004), Caesarean sections (P=0.0017) and instrumental deliveries (P=0.0013, all chi-square test). New-borns of “high risk” GDM mothers had significantly more often worse perinatal outcomes (Apgar score and macrosomia, chi-square test). Conclusion: Risk stratification of GDM subjects appears justified and might be a reliable tool for personalisation of prenatal and obstetric care. The possibility to predict also maternal postpartum metabolic outcomes using such risk stratification is a subject of our ongoing studies. Acknowledgement: Grant of Czech Ministry of Health no. 16-28040A |
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