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Pregnancy outcomes of early detected gestational diabetes: a retrospective comparison cohort study, Qatar
  1. Mohammed Bashir1,
  2. Khaled Baagar1,
  3. Emad Naem1,
  4. Fadi Elkhatib2,
  5. Noor Alshaybani2,
  6. Justin C Konje3,
  7. Abdul-Badi Abou-Samra1
  1. 1 Department of Endocrinology, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
  2. 2 Department of Obstetrics and Gynaecology, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar
  3. 3 Department of Obstetrics and Gynaecology, Sidra Medical, Doha, Qatar
  1. Correspondence to Mohammed Bashir; mohdbashir80{at}hotmail.com

Abstract

Objective To compare pregnancy outcomes in patients with early versus usual gestational diabetes mellitus (GDM).

Design A retrospective cohort study.

Settings The Women’s Hospital, Hamad Medical Corporation, Qatar.

Participants GDM women who attended and delivered in the Women’s Hospital, between January and December 2016. GDM was diagnosed based on the 2013-WHO criteria. The study included 801 patients; of which, 273 E-GDM and 528 U-GDM. Early GDM (E-GDM) and usual GDM (U-GDM) were defined as GDM detected before and after 24 weeks’ gestation, respectively.

Outcomes Maternal and neonatal outcomes and the impact of timing of GDM-diagnosis on pregnancy outcomes.

Results At conception, E-GDM women were older (mean age 33.5±5.4 vs 32.0±5.4 years, p<0.001) and had higher body mass index (33.0±6.3 vs 31.7±6.1 kg/m2, p=0.0059) compared with U-GDM. The mean fasting, and 1-hour blood glucose levels were significantly higher in E-GDM vs U-GDM, respectively (5.3±0.7 vs 4.0±0.7 mmol/L, p<0.001 and 10.6±1.7 vs 10.3±1.6 mmol/L, p<0.001). More patients in the U-GDM were managed on diet alone compared with E-GDM (53.6% vs 27.5%, p<0.001). E-GDM subjects gained less weight per week compared with U-GDM (0.02±0.03 vs 0.12±0.03 kg/week, p=0.0274). Maternal outcomes were similar between the two groups apart from a higher incidence of preterm labour (25.5% vs 14.4%; p<0.001) and caesarean section (52.4% vs 42.8%; p=0.01) in E-GDM vs U-GDM, respectively. After correction for covariates; gestational age at which GDM was diagnosed was associated with increased risk of macrosomia (OR 1.06, 95% CI 1.00 to 1.11; p<0.05) and neonatal hypoglycaemia (OR 1.05, 95% CI 1.00 to 1.11; p<0.05).

Conclusion Our data support the concept of early screening and treatment of GDM in high-risk patients. More data are needed to examine the optimal time for screening.

  • gestational diabetes
  • metformin
  • early gestational diabetes
  • gestational weight gain
  • obesity

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Patient consent for publication Not required.

  • Contributors MB designed the study, the data collection sheet, performed the statistical analysis and interpretation of data, and drafted the manuscript. KB, EN, FE and NA collected the data and reviewed the manuscript. Both Professors JCK and A-BA-S participated in the study design, data interpretation and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Internal Review Board (IRB), Hamad Medical Corporation.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data generated or analysed during this study are included in this published article. We do not have any other supplementary data.

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