The outcome of Gestational Diabetic pregnancies in the Maltese Islands

Abstract

Gestational diabetes is generally associated with a higher morbidity and mortality for both the mother and child. Aims: The study aims to assess the outcome indicators of women suffering gestational diabetes and compare these to the remaining obstetric population. Research Design and Methods: Outcome indicators of women diagnosed during pregnancy as suffering from diabetes (GDM (defined as a 2-hour post-load blood glucose of >=8.6 mmol/l) n=297) were compared to the parameters of women with a presumed normal carbohydrate metabolism (n = 16059). Results: The incidence of gestational diabetes in the Maltese pregnant population is 1.81 % of total maternities. Women with GDM showed themselves to be at a significantly increased risk of developing hypertensive disorders during pregnancy and to require delivery by caesarean section. They were more likely to require intervention by induction of labour, while the delivery was commonly complicated by shoulder dystocia. The infants born to GDM women were more likely to be macrosomic or preterm and have a low Apgar score at birth and suffer from respiratory distress. The infants did not show a greater predisposition to be of low birth weight. Conclusion: It would appear that gestational diabetes remains a high-risk situation that increases maternal and infant morbidity in spite of the modern management options.