Korean J Obstet Gynecol.  1998 Feb;41(2):593-601.

Pregnancy Outcomes According to the Status of Maternal Blood Glucose Control in Pregnant Women with Diabetes Requiring Insulin Therapy

Abstract


OBJECTIVE
To compare the pregnancy outcomes according to the status of maternal blood glucose control during pregnancy in women with diabetes requiring insulin therapy. Study design: Between 1986 and 1996, 83 pregnant women with diabetes who requires insulin therapy during pregnancy were identified; 29 cases with pregestational diabetes and 54 with gestational diabetes. The status of maternal blood glucose control was determined according to the mean HbA1c concentration (below or above 6.0% of HbA1c) during the third trimester of pregnancy. Pregnancy outcomes were compared between two groups of patients.
RESULTS
1) Patients with poor blood glucose control (HbA1c > 6.0%) had a significant higher rate of adverse outcome including cesarean delivery due to either fetal distress or cephalo-pelvic disproportion (20.0% vs. 2.9%, p<0.05), macrosomia of the newborn (> 90th percentile for gestation; 44.0% vs. 5.7%, p<0.0001), higher mean birth weight (3.61+/-1.12 kg vs 3.08+/-0.48 kg, p<0.005), and neonatal hypoglycemia at birth (42.2% vs. 12.1%, p<0.005); 2) The rate of preterm delivery (< 37 weeks of gestation) and pregnancy-induced hypertension was higher in patients with poor control (HbA1c > 6.0%) than those with good control (HbA1c< 6.0%) (16.0 % vs. 5.7% for each) without reaching statistical significance; 3) There was no statistical differences in the mean gestational age at birth and the rate of perinatal death between the two groups of patients.
CONCLUSIONS
Poor maternal glucose control is a risk factor for the development of adverse perinatal outcome including higher rate of fetal macrosomia, cesarean section, and neonatal hypoglycemia at birth.

Keyword

Diabetes; Insulin; Blood glucose control; Perinatal morbidity; Maternal morbidity

MeSH Terms

Birth Weight
Blood Glucose*
Cesarean Section
Diabetes, Gestational
Female
Fetal Distress
Fetal Macrosomia
Gestational Age
Glucose
Humans
Hypertension, Pregnancy-Induced
Hypoglycemia
Infant, Newborn
Insulin*
Parturition
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, Third
Pregnancy*
Pregnant Women*
Risk Factors
Blood Glucose
Glucose
Insulin
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