[Gestational diabetes. Diagnosis in early stages of the pregnancy]

To determine whether women with early diagnosis of gestational diabetes have an increase of the rate of gestational hypertensive disease, metabolic imbalance, higher insulin dosage requirement, perinatal morbidity and perinatal death than those in whom diabetes developed after 24th week.

All pregnant women with gestational diabetes were studied. Maternal age, pregestational body mass indexes, total weight gain during pregnancy, gestational age at diagnosis, and the timing of delivery were recorded. Two groups were studied: women with gestational diabetes diagnosed before 24 gestation weeks and those in which diabetes was diagnosed at 24 weeks or later. Total insulin dosage, rate of gestational hypertension, perinatal morbidity, perinatal death, and percentages of women with good metabolic control were analysed.

In the whole group 28% were diagnosed before 24 weeks of gestation. Women that were diagnosed earlier had grater pregestational body mass indexes (30 +/- 6 kg/m2 vs 27 +/- 6 kg/m2) and total weight gain during pregnancy was lower during over all gestation (8 +/- 5 kg vs 10 +/- 6 kg). Insulin requirements were higher in women diagnosed earlier and there were no differences in the rates of gestational hypertension, and perinatal death. Perinatal morbidity was significantly higher in patients who were diagnosed later

Early diagnosed and treatment may result in decreased perinatal morbidity. Women with early diagnosed diabetes required higher insulin dose, but they did not represent a high risk subgroup.