Gestational Diabetes Mellitus Risk Factors and Adverse Pregnancy Outcomes — ASN Events
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  3. Gestational Diabetes Mellitus Risk Factors and Adverse Pregnancy Outcomes

Gestational Diabetes Mellitus Risk Factors and Adverse Pregnancy Outcomes (#301)

Jessica Lai 1 , Vincent Wong 1 2 , Joyce Lim 3
  1. Department of Diabetes and Endocrinology, Liverpool Hospital, Liverpool, NSW, Australia
  2. South Western Clinical School, University of New South Wales, Sydney
  3. Hunter New England Health, NSW

Background: Pregnancies complicated by gestational diabetes mellitus (GDM) carry a higher risk of adverse outcomes for the foetus and mother.  The prevalence of GDM has increased over the past 10 years, and management of GDM has placed a great demand on the resources for hospital Diabetes Service.  It would be useful to be able to predict women who are likely to suffer adverse outcomes.  In this study we examined the incidence of adverse pregnancy outcomes according to the number of GDM risk factors.

Methods:  We conducted a retrospective study on our GDM database (between 2008 and 2014) at Liverpool Hospital, a tertiary referral centre in South Western Sydney.  The risk factors analysed in this study included previous GDM, maternal age >40 years, first degree family history of diabetes, body mass index >35kg/m2 and previous macrosomia.   Ethnicity was not included as 75% of all women who attended our service belonged to “high risk” ethnic groups.  Women with no risk factor were categorized as group 0, while groups 1, 2 and 3 represented women with 1, 2 or ≥3 risk factors.

Results:  A total of 2467 women with singleton pregnancy were included for analysis.  Large-for-gestational age (LGA) was seen in 3.97% of women in Group 0, 8.23% in Group 1, 17.26% in group 2 and 14.21% in group 3 [anova, p<0.001]. Caesarian section was recorded in 22.32% in patients in Group 0, 26.40% in Group 1, 24.49% in Group 2 and 31.68% in Group 3 [anova, p=0.0021]. This upward trend was also significant for neonatal hypoglycaemia (26.8%, 33.4%, 40.2% and 43.1%, [anova, p<0.001]) and peri-natal mortality data (0.76%, 1.26%, 2.62% and 2.40%, [anova, p=0.390]). The incidences for congenital abnormality and pre-eclampsia were not different between the groups.

Conclusion:  Our study showed that for women with GDM, the number of risk factors correlated with adverse pregnancy outcomes.  This risk stratification of women with GDM may help us streamline our service.  More resources will need to be invested in monitoring women who have multiple risk factors in an attempt to improve their pregnancy outcomes.