2019, Number 12
<< Back Next >>
Ginecol Obstet Mex 2019; 87 (12)
Maternal and fetal outcome in early and late diagnosis of gestational diabetes
Villota-Burbano D, Casillas-Barrera M, Morales-Morales MP, Farías-Barajas M, Mayagoitia-Miguel C
Language: Spanish
References: 22
Page: 785-791
PDF size: 225.89 Kb.
ABSTRACT
Objective: To compare the fetal maternal outcomes in patients with gestational
diabetes detected in the first and second half of pregnancy.
Materials and Methods: An observational, retrospective and analytical study
was carried out including all patients with gestational diabetes treated at the Women's
Hospital of Mexico City in the years 2014 to 2017. Were divided into two groups,
group 1 inserted those patients diagnosed between 13 and 20.6 weeks of gestation and
2 with subsequent diagnosis, the main maternal and fetal complications were identified
and compared. The results analysis included central trend measures, Student's t
and square Chi.
Results: 495 patients were included; Group 1 was composed of 147 pregnant women
and group 2 of 312. Maternal complications such as hypertensive disease of pregnancy
(32.7
vs 17.6% p 0.001), hyperthyroidism and hypothyroidism (7.5
vs 1.6% p 0.001)
were more frequent at the group 1. The birth weight (3054 ± 718.4
vs. 3156 ± 555.7
g. p 0.04), height (48.9 ± 3.49
vs 49.2 ± 2.7 cm p 0.05) and Capurro rating (37.9 ± 2.5
vs 38.2 ± 1.4 weeks p 0.01) were greater in infants in Group 2.
Conclusion: The maternal fetal outcome in patients with gestational diabetes are
modified by gestational age at the time of diagnosis, so greater emphasis should be
placed on the timely detection of these complications in order to reduce the impact of
gestational diabetes in the mother's binomial.
REFERENCES
Gabbe S. Management of diabetes mellitus complicating pregnancy. Obstet Gynecol. 2003; 102(4):857-68. https:// doi.org/10.1016/j.obstetgynecol.2003.07.001
Guía de práctica clínica. Diagnóstico y tratamiento de la diabetes en el embarazo (actualización 2016). México: Secretaría de Salud; 03/11/2016. http://www.cenetec.salud. gob.mx/descargas/gpc/CatalogoMaestro/320_IMSS_10_ Diabetes_embarazo/EyR_IMSS_320_10.pdf
Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019; 42 (Suppl. 1):S 13–S28. https://doi.org/10.2337/dc19-S002
Corrado F, et al. Perinatal outcome in a Caucasian population with gestational diabetes and preexisting diabetes first diagnosed in pregnancy. Diabetes Metab. 2016; 42(2):122-5. https://doi.org/10.1016/j.diabet.2015.11.007
Virally M, et al. Occurrence of gestational diabetes mellitus, maternal and fetal outcomes beyond the 28th week of gestation in women at high risk of gestational diabetes. A prospective study. Diabetes Metab. 2007; 33 (4): 290-5. https://doi.org/10.1016/j.diabet.2007.03.003
Sandoval RT, Oliva FB. Diabetes gestacional. Diagnóstico en etapas tempranas del embarazo. Ginecol Obstet Mex 2006; 74:199-204. https://ginecologiayobstetricia.org.mx/ secciones/articulos-originales-numero83/diabetes-gestacional- diagnostico-en-etapas-tempranas-del-embarazo/
Aviram A, et al. Pregnancy outcome in pregnancies complicated with gestational diabetes mellitus and late preterm birth. Diabetes Res Clin Pract. 2016; 113:198- 203. https:// doi.org/10.1016/j.diabres.2015.12.018
Gestational Hypertension and Preeclampsia ACOG Practice Bulletin. Obstet Gynecol 2019; 133(1): e1-e25. doi: 10.1097/AOG.0000000000003018
Thyroid Disease in Pregnancy ACOG Practice Bulletin. Obstet Gynecol 2015; 125 (4): 996-1005. doi: 10.1097/01. AOG.0000462945.27539.93
Kennelly MA, McAuliffe FM. Prediction and prevention of Gestational Diabetes: an update of recent literature. Eur J Obstet Gynecol Reprod Biol. 2016; 202:92-98. https://doi. org/10.1016/j.ejogrb.2016.03.032
Jarvela I, et al. Gestational Diabetes Identifies Women at Risk for Permanent Type 1 and Type 2 Diabetes in Fertile Age: Predictive role of autoantibodies. Diabetes Care 2016; 29(3):607-12. https://doi.org/10.2337/diacare.29.03.06. dc05-1118
Flores Padilla L, et al. Embarazo y obesidad: riesgo para desarrollo de diabetes gestacional en la frontera norte de México. Gaceta Médica de México. 2014; 150 (Supl 1):73-8 http://www.anmm.org.mx/GMM/2014/s1/ GMM_150_2014_S1_073-078.pdf
Lu MC, et al. Use of the National Diabetes Data Group and the Carpenter-Coustan criteria for assessing gestational diabetes mellitus and risk of adverse pregnancy outcome. BMC Pregnancy Childbirth. 2016; 16: 231. doi: 10.1186/ s12884-016-1030-9
Van der Ploeg H, et al. The role of pre-pregnancy physical activity and sedentary behavior in the development of gestational diabetes mellitus. J Sci Med Sport. 2011; 14(2):149- 52. https://doi.org/10.1016/j.jsams.2010.09.002
Schwartz N, et al. The prevalence of gestational diabetes mellitus recurrence--effect of ethnicity and parity: A metaanalysis. Am J Obstet Gynecol. 2015; 213(3):310-7. https:// doi.org/10.1016/j.ajog.2015.03.011
Feghali MN, et al. Pregnancy outcomes in women with an early diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract. 2018; 138: 177-86. doi: 10.1016/j. diabres.2018.02.004
Immanuel J, Simmons D. Screening and Treatment for Early-Onset Gestational Diabetes Mellitus: a Systematic Review and Meta-analysis. Curr Diab Rep 2017; 17:1 15-25. https://doi.org/10.1007/s11892-017-0943-7
Gong Li-Li, et al. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis. Taiwan J Obstet Gynecol 2016; 55: 171-5. https://doi. org/10.1016/j.tjog.2016.02.004
Corrales EP, et al. Is autoimmune thyroid dysfunction a risk factor for gestational diabetes? Endocrinol Nutr 2014; 61: 377-8
Vitacolonna E, et al. Gestational Diabetes and Thyroid Autoimmunity. Int J Endocrinol 2012; 2012:867415. http:// dx.doi.org/10.1155/2012/867415
Ryan DK, et al. Early screening and treatment of gestational diabetes in high-risk women improves maternal and neonatal outcomes: A retrospective clinical audit. Diabetes Res Clin Pract. 2018; 144: 294-301. https://doi.org/10.1016/j. diabres.2018.09.013
Hosseini E, et al. Comparison of risk factors and pregnancy outcomes of gestational diabetes mellitus diagnosed during early and late pregnancy. Midwifery 2018; 66: 64-9. doi: 10.1016/j.midw.2018.07.017. https://doi. org/10.1016/j.midw.2018.07.017