Pregnancy Outcomes in Women with Gestational Diabetes Depending on the Diagnosis Time
Abstract
Introduction: Gestational diabetes is the most common endocrine disorder in pregnancy and it is associated with unfavorable gestational outcomes.
Objective: To determine whether gestational diabetes diagnosed at 24-28 weeks is associated with better gestational outcomes than that identified later.
Methods: A retrospective correlational study was carried out for the years 2002-2012. One thousand one hundred fourteen women with gestational diabetes treated at América Arias Hospital in Havana were included. These were divided into two groups, five hundred forty-seven patients with a diagnosis made at 24-28 weeks (early) and 567 patients after 28 weeks. Clinical variables were analyzed: fasting risk blood glucose, initiation of treatment, insulin therapy and glycemic control, and gestational outcomes, including weight gain, mode and timing of pregnancy termination, large or macrosomic neonate, low Apgar score, and perinatal death. To compare qualitative (%) and quantitative variables (mean ± SD), the chi-square and Student's t tests (Mann-Whitney U) were used, respectively. Correlation of birth weight with other variables was determined. A statistically significant difference was assumed when p < 0.05.
Results: The early diagnosis group, earlier treatment was found (69.65 vs. 4.41%; p < 0.001), more insulin therapy (85.56 vs. 70.37%; p < 0.001) and less neonatal macrosomia (6.61 vs. 11.55%; p = 0.004). Gestational weight was positively correlated with the time of diagnosis (rho = 0.121; p < 0.001) and weight gain (rho = 0.139; p < 0.001).
Conclusions: Early diagnosis of gestational diabetes is associated with early treatment, insulin therapy and a decrease in neonatal macrosomia.
Keywords: gestational diabetes; early diagnostic; gestational outcomes.
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