Maternal and Neonatal Outcomes of Gestational Diabetes Mellitus in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with a range of maternal and neonatal complications. Maternal hyperglycaemia may contribute to polyhydramnios, hypertensive disorders and operative delivery, while neonatal consequences may include abnormal birth weight, hypoglycaemia, hyperbilirubinaemia and respiratory morbidity. This study evaluated maternal and neonatal outcomes among women with GDM managed at a tertiary-care hospital in Bangladesh. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from April to September 2013. Fifty-two women with GDM were enrolled by purposive sampling. Maternal complications, mode of delivery, birth weight and neonatal complications were recorded and analyzed using frequency and percentage. Results: Among maternal complications, UTI was most frequent (15.4%), followed by polyhydramnios (11.6%), vulvovaginitis (7.7%) and pre-eclampsia (3.8%). According to the detailed mode-of-delivery table, 88.5% of women underwent caesarean section and 11.5% had vaginal delivery. Normal birth weight was recorded in 80.8% of neonates, while 17.3% were macrosomic and 1.9% had low birth weight. Most neonates (73.1%) had no recorded complication. Hyperbilirubinaemia occurred in 15.4%, hypoglycaemia in 7.7%, IUGR in 1.9% and respiratory distress syndrome in 1.9%. No neonatal death was reported. Conclusion: Most women with GDM in this study had no recorded major maternal complication, although urinary infection and polyhydramnios were observed. Caesarean delivery was common. Most neonates had normal birth weight and no significant recorded complication, but macrosomia, hyperbilirubinaemia and hypoglycaemia remained clinically relevant outcomes. Careful maternal glycaemic control and neonatal monitoring are important in the management of GDM.