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Obstetric outcome of pregestational diabetic pregnancies
1Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
Insights
Pregnancies with pregestational diabetes have higher risks for congenital malformations, preterm delivery, and neonatal complications. Tight glycemic control and preconception counseling are crucial for improving outcomes in diabetic pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Endocrinology
Background:
- Pregestational diabetes significantly impacts maternal and infant health.
- Diabetic pregnancies are associated with increased risks of adverse outcomes.
Purpose of the Study:
- To evaluate obstetric and neonatal outcomes in pregestational diabetic pregnancies.
- To identify factors contributing to complications in these pregnancies.
Main Methods:
- Retrospective study design.
- Analysis of obstetric and neonatal data from 23 pregestational diabetic pregnancies.
- Comparison with a control population.
Main Results:
- Increased incidence of congenital malformations and mortality in infants of diabetic mothers.
- Higher rates of preterm delivery and Cesarean sections.
- Elevated neonatal morbidity including jaundice, hypoglycemia, respiratory distress, and NICU admissions.
Conclusions:
- Late antenatal booking and poor glycemic control are likely contributors to adverse outcomes.
- Preconception counseling and strict glycemic control throughout pregnancy are essential for reducing complications.
Abstract:
This retrospective study examined the obstetric and neonatal outcome in 23 pregestational diabetic pregnancies. The incidence of congenital malformations and mortality in infants of diabetic mothers was increased compared to the control population. Late booking for antenatal care and poor glycaemia control are probably the reasons for this high incidence. There was also a significantly higher preterm delivery and Caesarean section rate in the pregnancies complicated by pregestational diabetes. The neonatal morbidity was also higher than the controls in terms of jaundice, hypoglycaemia, respiratory distress syndrome and admissions to neonatal intensive care unit. Only with preconception counselling and tight glycaemia control in the periconception period and throughout pregnancy can we expect a drop in the complication rates in pregestational diabetic pregnancies.