Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes

Rev Bras Ginecol Obstet. 2019 Nov;41(11):647-653. doi: 10.1055/s-0039-1696947. Epub 2019 Nov 19.

Abstract

Objective: The present study aims to compare the maternal and fetal outcomes of parturients with and without a gestational diabetes diagnosis.

Methods: A case-control study including parturients with (cases) and without (control) a gestational diabetes diagnosis, who delivered at a teaching hospital in Southern Brazil, between May and August 2018. Primary and secondary data were used. Bivariate analysis and a backward conditional multivariate logistic regression were used to make comparisons between cases and controls, which were expressed by odds ratio (OR), with a 95% confidence interval (95%CI) and a statistical significance level of 5%.

Results: The cases (n = 47) were more likely to be 35 years old or older compared with the controls (n = 93) (p < 0.001). The cases had 2.56 times greater chance of being overweight (p = 0.014), and a 2.57 times greater chance of having a positive family history of diabetes mellitus (p = 0.01). There was no significant difference regarding weight gain, presence of a previous history of gestational diabetes, height, or delivery route. The mean weight at birth was significantly higher in the infants of mothers diagnosed with diabetes (p = 0.01). There was a 4.7 times greater chance of macrosomia (p < 0.001) and a 5.4 times greater chance of neonatal hypoglycemia (p = 0.01) in the infants of mothers with gestational diabetes.

Conclusion: Therefore, maternal age, family history of type 2 diabetes, obesity and pregestational overweightness are important associated factors for a higher chance of developing gestational diabetes.

Objetivo: O presente estudo tem como objetivo comparar os desfechos maternos e fetais das parturientes com e sem diagnóstico de diabetes gestacional. MéTODOS: Estudo caso-controle, incluindo parturientes com (casos) e sem (controle) diagnóstico de diabetes gestacional, que tiveram parto em um hospital de ensino no Sul do Brasil, entre maio e agosto de 2018. Foram utilizados dados primários e secundários. Análise bivariada e regressão logística multivariada condicional retrógrada foram utilizadas para fazer comparações entre casos e controles, expressas por razão de probabilidades (RP), com intervalo de confiança de 95% (IC95%) e nível de significância estatística de 5%.

Resultados: Os casos (n = 47) tiveram maior chance de ter idade superior a 35 anos em comparação com os controles (n = 93) (p < 0,001), chance 2,56 vezes maior de estarem acima do peso (p = 0,014), e chance 2,57 vezes maior de terem história familiar positiva de diabetes mellitus (p = 0,01). Não houve diferença significativa relacionada ao ganho de peso, história pregressa de diabetes gestacional, estatura ou via de parto. O peso médio ao nascer foi significativamente maior nos lactentes de mães com diabetes gestacional (p = 0,01). Houve 4,7 vezes maior chance de macrossomia (p < 0,001), e 5,4 vezes maior chance de hipoglicemia neonatal (p = 0,01) em lactentes de mães com diabetes gestacional. CONCLUSãO: Portanto, idade materna, história familiar de diabetes tipo 2, obesidade e excesso de peso pré-gestacional são importantes fatores associados a uma maior chance de desenvolvimento de diabetes gestacional.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight
  • Brazil
  • Case-Control Studies
  • Diabetes, Gestational* / physiopathology
  • Female
  • Fetal Macrosomia / etiology
  • Genetic Predisposition to Disease
  • Hospitals, Teaching
  • Humans
  • Hypoglycemia / etiology
  • Maternal Age
  • Obesity, Maternal / complications
  • Obesity, Maternal / physiopathology
  • Pregnancy
  • Pregnancy Outcome*
  • Weight Gain
  • Young Adult