OBJECTIVE: To evaluate to prevalence of Gestational diabetes in the infertile population in India and its impact on pregnancy
DESIGN: An ongoing observational study of 400 pregnant women treated for subfertility in a tertiary referral centre.
MATERIALS AND METHODS: Baseline parameters of 400 pregnant women treated for infertility were noted including fasting sugars, glycosylated Hb and their progress through pregnancy was charted with assessment of 75 gms OGTT at 28 weeks of gestation and doppler blood flow at different stages and eventually fetal birth weight.Microsoft excel 2011 was used for analysis.
RESULTS: Mean age of the pregnant women was 30.1+/-4.2 years with a mean BMI of 24.3+/- 4.2 kg/ sqm. Mean Plasma glucose at 12 weeks was 102.7+/-15.3 mg% and HBA1c was 5.6 +/-0.4%. Only 15.3% women had a HBA1c >5.7% at booking.38% had a h/o PCOS, 31.5% had h/o Unexplained infertility and 16.5% had h/o Male factor infertility. 54.3% women conceived through ART while 45.7% with follicular monitoring and timed intercourse.At 28 weeks, 33.2%women had a deranged profile following 75gms OGTT. 34.1% were managed with diet modification, 36.5% were given oral antidiabetics and 29.4% needed insulin.36.4% women with PCOS had an abnormal GTT as compared with 30.3% (p=ns).23% women with abnormal GTT developed PIH as compared with 10.44% cases with normal GTT.(p = 0.013 significant)The mean gestational age at delivery was 37+/-3.6 weeks and there was no significant difference in the birth weight of babies born to mothers with abnormal GTT (2.8+/-0.55 kg) when compared with those with normal GTT (2.8+/-0.64kg).
CONCLUSIONS: Nearly 1/6th women have an impaired glucose tolerance at antenatal booking and by 28 weeks a third (1/3) of women develop GDM. The onset of PIH in cases with GDM significantly higher (x2) and this needs vigilance and treatment.When managed effectively, the pregnancy outcomes in GDM cases are similar to the normal cohort.