A Comparative Study on Outcome between Pregnant Woman with GDM with Obesity and Pregnant Woman with GDM without Obesity

Background: Pregnancy with diabetes is one of the most important medical and endocrine logical disorders encountered in obstetrical practice. Patients when develop carbohydrate intolerance first time during present pregnancy are recognized as Gestational Diabetes Mellitus (GDM). Pregnancy and diabetes affect each other adversely. Obesity is one of the common nutritional problems complicating pregnancy in developed countries. There is a strong association between maternal obesity and gestational diabetes mellitus.

Objectives: To evaluate the maternal and perinatal outcomes of GDM patients at the time of delivery. And to compare maternal and perinatal outcome between obese and non-obese GDM pregnant women.

Methods: This was a analytical cross sectional study conducted in the in department of Obstetric and Gynaecology in Medical College for women and Hospital, Uttara, Dhaka during the period of July 2012 to December 2012. Sixty pregnant women with GDM from 20 weeks onwards, who were on regular antenatal check up, attending in OPD were the study population. Among them 30 patients were obese having BMI ≥ 30kg/m2 and 30 patient having BMI < 30kg/m2 .

Results: This study was conducted to observe the effect of obesity on the pregnancy outcome of GDM patients. Vulvovaginitis was more in the GDM with obese patient than GDM without obesity, which was 23.33% Vs 10% respectively. The rate of caesarean sections was higher in both the diabetic group (GDM with obesity 90%, GDM without obesity 86.7%). The frequencies of both elective and emergency section are almost twice as high for very obese women as it is for women of normal BMI. The incidence of foetal distress is 10% in obese group and 3.3% in non-obese group.

Conclusion: Gestational diabetes is not uncommon and it is often associated with higher incidence of maternal and perinatal morbidity and mortality. The finding of this study indicate that obesity in GDM patients is associated with more pregnancy complications. Thus, pre pregnancy weight reduction and appropriate weight gain during antenatal period in women with gestational diabetes might reduce the pregnancy and labour complications and improve maternal and perinatal outcome.