Pregnancy Outcomes in Diabetic Mothers with Controlled Glycemia: A Case-Control Study

Background: Overt Diabetes mellitus and Gestational diabetes mellitus (GDM) can complicate pregnancy. Early detection and management of the disease should be done to ensure better maternal and foetal outcomes. Our goal is to compare treatment-controlled diabetic women with non-diabetic women to evaluate the pregnancy-related unfavourable outcomes.

Methods and Materials: This is a single-centre case-control study with women, from Nellore, Andhra Pradesh, who gave birth between September 2022 and February 2023. A total of 144 patients, including 72 women with diabetes and controlled glycemia (case group, n=72), were compared with non-diabetic women (control group, n=72). Various pregnancy-related outcomes were observed. The student t-test and SPSS were used for statistical analysis to compare

Results: Average ages were 24±4.9 years and 27.83±6.24 years in controls and cases, respectively. Mean pregnancy duration was 268.15±7.1 days in controls and 257.1±31.2 days in cases. The cases had a mean HbA1C of 6.05%, indicating controlled levels. Caesarean births were observed in 75% of cases and 51.3% of controls. While macrosomia (>4 kg) was not observed, 25% of cases had low birth weight (<2.5 kg). Family history, gravidity, consanguinity, newborn sex, APGAR score, nuchal cord, asphyxia, and need for respiratory support did not significantly differ between the cases and controls. However, there was a significant difference (p<0.05) in the gestation period, previous neonatal loss, type of previous deliveries, caesarean delivery, baby weight, hyperbilirubinemia, and present neonatal loss between diabetic mothers and non-diabetic mothers.

Conclusion: A well-managed chronic hyperglycaemia was thought to prevent multiple pregnancy-related problems for both the mother and the baby. This study aimed to investigate this point. Though many complications were avoided with controlled glycemia in our study, complications such as caesarean deliveries, preterm births, low birth weight, hyperbilirubinemia, and neonatal loss were more prevalent in cases. This highlights the need for further research, especially in understanding and possibly intensifying glycaemic goals for diabetic mothers.