Forsbach-Sánchez G, Vásquez-Lara J, Hernández-Herrera R, Tamez-Pérez HE

Language: Spanish
References: 13
Page: 141-144
PDF size: 95.04 Kb.

ABSTRACT

Introduction: women with gestational diabetes have an increase risk for maternal and neonatal metabolic complications.
Objective: to evaluate detection, treatment and close surveillance.
Methods: we recruited all women with gestational diabetes whose pregnancies ended in this hospital between September to November of 2005. All newborns were examined by a neonatologist and initiated early feeding with infant formula or glucose solution.
Results: a total of 74 patients with gestational diabetes were included. The age was 31.03 ± 4.79 years, and the body mass index before pregnancy was 32.31 ± 6.41. Eighteen patients developed third-trimester complications, in fourteen of them it was hypertensive disease of pregnancy. All were single pregnancies that ended in 71 term and 3 preterm newborns. There were not fetal or perinatal deaths. There were four small newborns for gestational age, 18 large for gestational age and 52 normal weight newborns. Eleven neonates had metabolic complications, eight of them had idiopathic respiratory distress syndrome, four had hypoglycaemia and one large for gestational age had obstetric trauma. Also two neonates with cardiovascular malformations were diagnosed. Thirty six mothers returned for revaluation, eight had type 2 diabetes, six glucose intolerance.
Conclusions: this group of patients shows the maternal and neonatal morbidity associated to gestational diabetes in patients under close surveillance. Systematic early screening in women at risk and close surveillance are required to obtain healthy newborns.

REFERENCES

1. Forsbach-Sánchez G, González-Obele F, Villanueva-Cuéllar MA, Taméz-Pérez HE, Rocha-Márquez J. Impacto del nuevo criterio de diabetes gestacional en la estimación de su prevalencia. Rev Invest Clin 2003;55:507-510.

2. The 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 2006;26:S5-S20.

3. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation. Part 1. Diagnosis and classification of diabetes mellitus. Geneva: WHO; 1999.

4. Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop- Conference on Gestational Diabetes Mellitus. Diabetes Care 1998;21(Suppl 2):B161-B167.

5. Carrapato MR, Marcelino F. The infant of the diabetic mother. The critical development windows. Early Pregnancy 2001;5:57-58.

6. Langer O, Yogev Y, Mart O, Xenakis EM. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol 2005;192:989-997.

7. Battaglia FC, Lubchenko LO. A practical classification of newborn infants by birth weight and gestational age. J Pediatr 1967;71:159-163.

8. Sistema Nacional de Información en Salud. Principales causas de mortalidad general 2000- 2005. Disponible en http://sinais.salud.gob.mx/mortalidad/mortalidad/htm

9. Aguilar-Salinas CA, Monroy OV, Gómez-Pérez FJ, Chávez AG, Lara AE, Cuevas VM, et al. Characteristics of patients with type 2 diabetes in Mexico: results from a large population based nation-wide survey. Diabetes Care 2003;26:2021-2026.

10. Innes KE, Wimsatt JH. Pregnancy induced hypertension and insulin resistance: evidence for a connection. Acta Obstet Gynecol Scand 1999; 78:263-284.

11. Uvena-Celebrezze J, Catalano P. The infant of the women with gestational diabetes mellitus. Clin Obstet Gynecol 2000;43:127-139.

12. Carrapato MRG. The offspring of gestational diabetes. J Perinat Med 2003;31:5-11.

13. Wren C, Birrell H, Hawthorne G. Cardiovascular malformations in infants of diabetic mothers. Heart 2003;89:1217-1220.