Obstetric results of the multicenter, nationwide, scientific-educational program for pregnant women with gestational diabetes mellitus (GDM)

Abstract

Objectives: The aim of the present study was to compare the obstetric results in women with GDM in a Polish population based on the criterion for the diagnosis of GDM.

Material and methods: The study was a questionnaire study covering the data of 2853 patients with GDM treated in centers nationwide in the years 2011–2013. The principles of self-control, glycemic targets and treatment were based on the then-current PDA guidelines. Analysis of the collected data included an assessment of obstetric results based on the diagnostic criteria for GDM. Depending on the result of the glucose tolerance test, the patients were divided into subgroups.

Results: 6.28% of births were preterm, and 47% were caesarean. A significant difference was observed in the number of preterm births between a subgroups: PDA(+) meeting only criterion 0’ and a PDA(+)meeting only criterion 120’ (16.67% vs. 5.83%); and between WHO(+) subgroup meeting only criterion 0’ with respect to the subgroup PDA(+) meeting only criterion 0’ (4.69% vs. 16.67%). Significant difference was found in the frequency of LGA between the WHO(-)PDA(+) and WHO(+)PDA(-) subgroups (6,57% vs. 14.93%), and between the WHO(-)PDA(+) group and a group of isolated hyperglycemia in 60’(6.57% vs. 12.5%). Also a significant positive correlation was observed between birth weight, the occurrence of LGA and macrosomia, and maternal weight and BMI before pregnancy.

Conclusions: The results of the analysis indicate the new criteria have greater sensitivity in the prediction of prematurity and birth weight. However, it cannot be ruled out that the final results were affected by the therapeutic intervention employed.