Vol 3, No 4 (2014)
Research paper
Published online: 2014-09-22

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Analysis of maternal factors and pregnancy outcomes in women with gestational diabetes mellitus. Results of the scientific and educational programme “We care for the Mothers”

Katarzyna Cypryk, Ewa Wender-Ożegowska, Marcin Kosiński, Łukasz Bartyzel, Danuta Olejniczak, Krzysztof Czajkowski, Elżbieta Kramarczuk, Marek Chowaniec, Monika Żurawska-Kliś, grupa badaczy Dbamy o Mamy
Diabetologia Kliniczna 2014;3(4):144-156.

Abstract

Aim. The aim of the study was to analyze maternal factors and obstetric outcomes in the women with gestational diabetes mellitus (GDM) in the polish population.

Material and methods. The programme “We care for the Mothers” was a prospective, multicenter observational study that allowed to establish a database of 2853 patients with gestational diabetes treated between 2011 and 2013 in 42 diabetological departments in Poland. Diagnostic criteria, blood glucose self-control principles, glycemic targets and treatment principles were based on the guidelines of the Polish Diabetes Association 2011. The programme was based on the questionnaire, in which data concerning medical history (including obstetric data), anthropometric data, data concerning GDM treatment as well as the data concerning current pregnancy were gathered. All the data were then statistically analyzed.

Results. 75 g OGTT result was available in 2497 women, of which GDM was ultimately diagnosed in 2408 patients. The mean age at the diagnosis was 30.59 ± 4.88 years (15.9% women > 35 years of age), BMI before conception was 24.75 kg/m2. The most frequent GDM risk factors were: history of pregnancy (61.46%), history of diabetes in the family (49.21) as well as overweight and obesity in the women (40.16%). At least one GDM risk factor was noted in 86.97% of the analyzed population. Insulin therapy was introduced in 23.83%; the higher BMI prior to conception the higher the frequency if insulin therapy was. Preterm delivery were observed in 6.36%, and 47% of deliveries was ended via cesarean section. Mean birth weight of the neonate was 3344 g; LGA and macrosomy rate was 8.59% and 9.77%, respectively. In the women with overweight or obesity, comparing to the group with normal weight, higher rate of LGA (p < 0.05) and higher neonatal birth weight (p < 0.001) was observed. No correlation between birth weight, LGA, SGA nor macrosomy of the neonates and gestational weight gain, fasting or postload glycemia in 75 g OGTT was observed. No significant differences in obstetric outcomes were noted as concerned GDM treatment, age and the number of previous pregnancies.

Conclusions. The women that suffer from GDM in Poland are usually around 30 years old, with normal weight, history of pregnancy in the past and at leastone GDM risk factor. One in four women requires insulin therapy. Women with GDM usually give birth to a full-term newborn with normal birth weight, and in about 10% the neonate with excessive birth weight, significantly more often in overweight or obese mothers. Neither age of the women, OGTT result, nor the mode of treatment have the impact on obstetric outcomes.