CORRELATION BETWEEN DIAGNOSIS TIME AND METHODS OF GESTATIONAL DIABETES MELLITUS ON OBSTETRIC COMPLICATIONS

Abstract

To evaluate and compare the correlation between the gestational diabetes mellitus (GDM) diagnosis time and method on women who gave birth at the Department of Obstetrics and Gynecology in the Hospital of Lithuanian University of Health Sciences Kauno klinikos. Methods. A retrospective study was performed using the data from the Department of Obstetrics and Gynecology of the Lithuanian University of Health Sciences (LUHS) Birth Registry to analyze the data of woman who gave birth and had GDM in 2020. According to the time and method of diagnosis of GDM, the subjects were divided into two groups: GDM was diagnosed at the first antenatal visit, when fasting venous plasma glycemia was ≥5.1 mmol/l (early diagnosis group) or after OGTT at 24+0–28+6 weeks of gestation when at least one pathological glycemic index was observed: fasting glycemia 5.1–6.9 mmol/l or 1 hour glycemia ≥10.0 mmol/l or 2 hours glycemia 8.5–11.0 mmol/l (late diagnosis group). The results were processed and systematized using MO Excel and IBM SPSS. Chi square (χ2) and t tests were used, the results were considered significant when p < 0.05. Results. The early diagnosis group of GDM had 557 (63.3 %) pregnant women, the late diagnosis group had 323 (36.7 %). More primigravida and nulliparous women were likely to be in the late diagnosis group (p = 0.049 and p = 0.031). More obese women were in the early diagnosis group (p = 0.047) with a BMI >40 (p = 0.021). In the early diagnosis group, GDM was more frequently diagnosed for women who gained <11 kg (p = 0.002) during pregnancy, in the late diagnosis group who gained >16 kg (p = 0.001). Fasting glycemia was higher in the early diagnosis group (p = 0.017). Glycemia was more commonly corrected with lifestyle changes between women in the late diagnosis group (p = 0.014), and lifestyle changes with insulin therapy in the early diagnosis group (p = 0.007). Polyhydramnios and preeclampsia were more common in women in the late diagnosis group (p = 0.010 and p = 0.032). There were more large for gestational age newborns in the late diagnosis group (p = 0.028). Macrosomy was more common in the late diagnosis group (p = 0.016). Induction of labor was more common in the late diagnosis group (p = 0.003). Conclusions. GDM is more commonly diagnosed with OGTT in primigravida and nulliparous women. Higher pregestational weight and BMI is associated with early diagnosed GDM by fasting glycemia and need for insulin therapy in combination with lifestyle changes. Late diagnose of GDM is more often associated with obstetric complications.