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A ten-year gestational diabetes mellitus cohort at a university clinic of the mid-Anatolian region of Turkey.
Clin Exp Obstet Gynecol. 2005; 32(4):241-4.CE

Abstract

OBJECTIVE

The study attempts to analyze a 10-year retrospective cohort of gestational diabetes mellitus (GDM) cases, elucidating the maternal complications and perinatal morbidity and mortality.

STUDY DESIGN

The study participants were 110 diabetic singleton pregnancies receiving obstetric care at the Department of Obstetrics and Gynecology, Osmangazi University School of Medicine in Eskisehir, Turkey from January 1995 to December 2004. In 70 of the GDM cases, mean age, diagnostic criteria used to define GDM, gestational age at delivery, presence of additional risk factors, method of clinical management, mode of delivery, fetal birthweights and newborn characteristics were assessed.

RESULTS

The prevalence of GDM in the past ten-year period was 3.1% (110/3548). Mean age of enrolled GDM cases was 32.6 +/- 5.3 years. With regard to diagnostic criteria of GDM, 24 (37.1%) cases were diagnosed based on a 100 g, three-hour oral glucose tolerance test (OGTT), while 18 (25.7%) cases were referred to our unit without any information on the specific criteria of GDM diagnoses. In less than a third of the cases (25.7%), a one-hour 50 g glucose challenge test (GCT) resulted > or =185 mg/dl completing the diagnoses. More than half of the cases (57.1%) revealed controlled glucose homeostasis on diet, while 30 (42.9%) pregnant women needed insulin therapy to control blood glucose levels to within normal physiologic limits. Fetal macrosomia was present in 18 (25.7%) pregnancies. Meanwhile, most of the fetuses (62.9%) were within the normal growth percentiles throughout the pregnancy. There was no difference detected in body mass index (BMI) of women undergoing cesarean section and spontaneous vaginal births (25.1 +/- 1.2 vs 26.2 +/- 2.3 kg/m2, respectively, p = 0.45). Vacuum extraction and forceps applications were indicated in 10% of all GDM groups. Fetuses born to women having cesarean section were heavier at birth compared to those of women having vaginal births (3940 +/- 320 g vs 430 +/- 117 g, p = 0.08) Most frequent neonatal morbidity was hyperbilirubinemia in 25 (35.7%) newborns. Interestingly, of those women with GDM, only ten (14.3%) cases consented to follow-up evaluation of glucose intolerance between six and eight weeks postpartum.

CONCLUSIONS

Proposed risks from abnormal glucose intolerance in pregnancy are multiple. Early diagnosis, patient education, proper follow-up and postpartum testing in women with GDM will certainly decrease poor perinatal outcomes, enabling also a secondary prevention of type 2 diabetes in the long term.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Osmangazi University School of Medicine, Meselik Kampusu, Eskisehir, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16440823

Citation

Tanir, H M., et al. "A Ten-year Gestational Diabetes Mellitus Cohort at a University Clinic of the mid-Anatolian Region of Turkey." Clinical and Experimental Obstetrics & Gynecology, vol. 32, no. 4, 2005, pp. 241-4.
Tanir HM, Sener T, Gürer H, et al. A ten-year gestational diabetes mellitus cohort at a university clinic of the mid-Anatolian region of Turkey. Clin Exp Obstet Gynecol. 2005;32(4):241-4.
Tanir, H. M., Sener, T., Gürer, H., & Kaya, M. (2005). A ten-year gestational diabetes mellitus cohort at a university clinic of the mid-Anatolian region of Turkey. Clinical and Experimental Obstetrics & Gynecology, 32(4), 241-4.
Tanir HM, et al. A Ten-year Gestational Diabetes Mellitus Cohort at a University Clinic of the mid-Anatolian Region of Turkey. Clin Exp Obstet Gynecol. 2005;32(4):241-4. PubMed PMID: 16440823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A ten-year gestational diabetes mellitus cohort at a university clinic of the mid-Anatolian region of Turkey. AU - Tanir,H M, AU - Sener,T, AU - Gürer,H, AU - Kaya,M, PY - 2006/1/31/pubmed PY - 2006/3/31/medline PY - 2006/1/31/entrez SP - 241 EP - 4 JF - Clinical and experimental obstetrics & gynecology JO - Clin Exp Obstet Gynecol VL - 32 IS - 4 N2 - OBJECTIVE: The study attempts to analyze a 10-year retrospective cohort of gestational diabetes mellitus (GDM) cases, elucidating the maternal complications and perinatal morbidity and mortality. STUDY DESIGN: The study participants were 110 diabetic singleton pregnancies receiving obstetric care at the Department of Obstetrics and Gynecology, Osmangazi University School of Medicine in Eskisehir, Turkey from January 1995 to December 2004. In 70 of the GDM cases, mean age, diagnostic criteria used to define GDM, gestational age at delivery, presence of additional risk factors, method of clinical management, mode of delivery, fetal birthweights and newborn characteristics were assessed. RESULTS: The prevalence of GDM in the past ten-year period was 3.1% (110/3548). Mean age of enrolled GDM cases was 32.6 +/- 5.3 years. With regard to diagnostic criteria of GDM, 24 (37.1%) cases were diagnosed based on a 100 g, three-hour oral glucose tolerance test (OGTT), while 18 (25.7%) cases were referred to our unit without any information on the specific criteria of GDM diagnoses. In less than a third of the cases (25.7%), a one-hour 50 g glucose challenge test (GCT) resulted > or =185 mg/dl completing the diagnoses. More than half of the cases (57.1%) revealed controlled glucose homeostasis on diet, while 30 (42.9%) pregnant women needed insulin therapy to control blood glucose levels to within normal physiologic limits. Fetal macrosomia was present in 18 (25.7%) pregnancies. Meanwhile, most of the fetuses (62.9%) were within the normal growth percentiles throughout the pregnancy. There was no difference detected in body mass index (BMI) of women undergoing cesarean section and spontaneous vaginal births (25.1 +/- 1.2 vs 26.2 +/- 2.3 kg/m2, respectively, p = 0.45). Vacuum extraction and forceps applications were indicated in 10% of all GDM groups. Fetuses born to women having cesarean section were heavier at birth compared to those of women having vaginal births (3940 +/- 320 g vs 430 +/- 117 g, p = 0.08) Most frequent neonatal morbidity was hyperbilirubinemia in 25 (35.7%) newborns. Interestingly, of those women with GDM, only ten (14.3%) cases consented to follow-up evaluation of glucose intolerance between six and eight weeks postpartum. CONCLUSIONS: Proposed risks from abnormal glucose intolerance in pregnancy are multiple. Early diagnosis, patient education, proper follow-up and postpartum testing in women with GDM will certainly decrease poor perinatal outcomes, enabling also a secondary prevention of type 2 diabetes in the long term. SN - 0390-6663 UR - https://www.unboundmedicine.com/medline/citation/16440823/A_ten_year_gestational_diabetes_mellitus_cohort_at_a_university_clinic_of_the_mid_Anatolian_region_of_Turkey_ L2 - http://www.diseaseinfosearch.org/result/7025 DB - PRIME DP - Unbound Medicine ER -