Obstetric-Neonatal Complications of Gestational Diabetes: A Systematic Review

Keywords: Gestational diabetes, obstetric complications, neonatal complications, review

Abstract

Analyse the evidence provided regarding neonatal and obstetric complications derived from gestational diabetes. A systematic search of the scientific literature, PUBMED, ScienceDirect was carried out with various search strategies guaranteeing the completeness and reproducibility of the phases of the PRISMA guide. 13 studies were included, 10 simultaneously evaluated obstetric and neonatal complications, the rest (3) evaluated only neonatal complications. The prevalence of GDM (gestational diabetes mellitus) was 12.5% (65,852 of 527,351) Obstetric complications include: emergency caesarean section (OR 1.1 to 2.37), preeclampsia with an OR range of 1.1 to 2.96, and prematurity (OR 1.1 to 2.3). The most frequent neonatal complications are: macrosomia with an OR range of 1.2 to 5.2, with a prevalence of 10.3%; while hypoglycaemia is the one with the highest risk (OR 3.19-11.97), other complications include greater height for gestational age OR 1.3 to 3.43; perinatal asphyxia (OR 1.2-3.4); shoulder dystocia (OR 1.3-2.56); respiratory distress (OR 1.3-2) and hyperbilirubinemia (OR 1.02-1.39). No increased risk of perinatal death was found, the reported OR range is 0.7-0.8. Both obstetric and neonatal gestational diabetes complications are very prevalent and may require intensive care, being a highly relevant public health problem. Although an efficient screen for the early detection of gestational diabetes has been established, greater efforts are required to comply with it and to avoid these complications.

 

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References

Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res. Clin. Pract. 103, 341–363 (2014).

Centers for Disease Control and Prevention. Gestational Diabetes. https://www.cdc.gov/diabetes/basics/gestational.htm (2021).

Evidencias y Recom. Guía Práctica Clínica. Diagnóstico y tratamiento de la diabetes en el embarazo. (2016).

Berkowitz, G. S., Lapinski, R. H., Wein, R. & Lee, D. Race/ethnicity and other risk factors for gestational diabetes. Am. J. Epidemiol. 1992; 135: 965–973.

Di Cianni, G. et al. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res. Clin. Pract. 2003; 62: 131–137.

Johns, E. C., Denison, F. C., Norman, J. E. & Reynolds, R. M. Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends Endocrinol. Metab. 2018; 29: 743–754.

Choudhury, A. A. & Devi Rajeswari, V. Gestational diabetes mellitus - A metabolic and reproductive disorder. Biomed. Pharmacother. 2021; 143: 112-183.

Bougherara, L., Hanssens, S., Subtil, D., Vambergue, A. & Deruelle, P. Diabetes gestacional. EMC – Ginecol. 2018; 54: 1–11.

Kulshrestha V, Agarwal N. Maternal complications in pregnancy with diabetes. J. Pak. Med. Assoc. 2016 ;66 (9 Suppl 1):S74–7.

Schmidt CB, Voorhorst I, Van De Gaar VHW, Keukens A, Potter Van Loon BJ, Snoek FJ, et al. Diabetes distress is associated with adverse pregnancy outcomes in women with gestational diabetes: A prospective cohort study. BMC Pregnancy Childbirth 2019; 19(1): 1–9.

Dalfrà MG, Nicolucci A, Bisson T, Bonsembiante B, Lapolla A. Quality of life in pregnancy and post-partum: a study in diabetic patients. Qual. Life Res. 2012; 21(2): 291–8.

Rahman MA, Khan N, Rahman MM. Maternal anaemia and risk of adverse obstetric and neonatal outcomes in South Asian countries: a systematic review and meta-analysis. Public Health Pract. 2020; 1: 100021.

Szmuilowicz ED, Josefson JL, Metzger BE. Gestational Diabetes Mellitus. Endocrinol. Metab. Clin. North Am. 2019;48(3):479.

Lende M, Rijhsinghani A. Gestational diabetes: Overview with emphasis on medical management. Int. J. Environ. Res. Public Health 2020; 17(24): 1–12.

O’Sullivan EP, Avalos G, O’Reilly M, Dennedy MC, Gaffney G, Dunne F. Atlantic Diabetes in Pregnancy (DIP): The prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria. Diabetologia 2011; 54(7): 1670–5.

Fadl HE, Östlund IKM, Magnuson AFK, Hanson USB. Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003. Diabet. Med. 2010; 27(4): 436–41.

Muche AA, Olayemi OO, Gete YK. Gestational diabetes mellitus increased the risk of adverse neonatal outcomes: A prospective cohort study in Northwest Ethiopia. Midwifery 2020; 87: 102713.

Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int. J. Womens Health 2011; 3(1): 367.

Bodmer-Roy S, Morin L, Cousineau J, Rey E. Pregnancy outcomes in women with and without gestational diabetes mellitus according to the international association of the diabetes and pregnancy study groups criteria. Obstet. Gynecol. 2012; 120(4): 746–52.

Bhat M, Ramesha KN, Sarma SP, Menon S, Ganesh Kumar S. Outcome of gestational diabetes mellitus from a tertiary referral center in south India: A case-control study. J. Obstet. Gynecol. India 2012; 62(6): 644–9.

AlFaleh K, Al-Alaiyan S, Al-Khalifah R, Al-Subaihin A, Al-Kharfi T. Neonatal short-term outcomes of gestational diabetes mellitus in Saudi mothers: A retrospective cohort study. J. Clin. Neonatol. 2012; 1(1): 29.

Ovesen PG, Jensen DM, Damm P, Rasmussen S, Kesmodel US. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes. A nation-wide study. J. Matern. Neonatal Med. 2015; 28(14): 1720–4.

Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A, et al. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia 2017; 60(4): 636–44.

1. Thiruvikrama Prakash G, Das AK, Habeebullah S, Bhat V, Shamanna SB. Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian J. Endocrinol. Metab. 2017; 21(6): 854–8.

Basri NI, Mahdy ZA, Ahmad S, Abdul Karim AK, Shan LP, Abdul Manaf MR, et al. The World Health Organization (WHO) versus The International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes. Horm. Mol. Biol. Clin. Investig. 2018; 34(1).

Blackwell SC, Landon MB, Mele L, Reddy UM, Casey BM, Wapner RJ, et al. Relationship between Excessive Gestational Weight Gain and Neonatal Adiposity in Women with Mild Gestational Diabetes Mellitus. In: Obstetrics and Gynecology Obstet Gynecol; 2016. p. 1325–32.

Werner EF, Romano ME, Rouse DJ, Sandoval G, Gyamfi-Bannerman C, Blackwell SC, et al. Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity. Obstet. Gynecol. 2019; 133(2): 349–53.

Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: A systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18(1).

Organizacion Panamericana de la salud, Salud OM de la, organizacioon Mundial de la Diabates. Informe final de la Conferencia Panamericana sobre Diabetes y Embarazo. Pho/Who 2015: 1–76.

Orozco LT. Preeclampsia, viejo problema aún no resuelto: conceptos actuales. Rev. Peru Ginecol. Obstet. 2014; 1–11.

Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: A literature review. Ann. Nutr. Metab. 2015; 66(Suppl. 2): 14–20.

Lazer S, Biale Y, Mazor M, Lewenthal H, Insler V. Complications associated with the macrosomic fetus. J. Reprod. Med. Obstet. Gynecol. 1986; 31(6): 501–5.

Voormolen DN, De Wit L, Van Rijn BB, Hans DeVries J, Heringa MP, Franx A, et al. Neonatal hypoglycemia following diet-controlled and insulin-treated gestational diabetes mellitus. Diabetes Care 2018; 41(7): 1385–90.

Dudley DJ. Diabetic-associated stillbirth: incidence, pathophysiology, and prevention. Clin. Perinatol. 2007; 34(4): 611–26.

Arendt LH, Pedersen LH, Pedersen L, Ovesen PG, Henriksen TB, Lindhard MS, et al. Glycemic Control in Pregnancies Complicated by Pre-Existing Diabetes Mellitus and Congenital Malformations: A Danish Population-Based Study. Clin. Epidemiol. 2021; 13: 615.

Published
2022-06-22
How to Cite
Valdez Vargas, S. E., & Chávez-González , E. L. (2022). Obstetric-Neonatal Complications of Gestational Diabetes: A Systematic Review. Mexican Journal of Medical Research ICSA, 11(21), 1-8. Retrieved from https://repository.uaeh.edu.mx/revistas/index.php/MJMR/article/view/8536