Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)
Aim: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). Materials and Methods: Records of pregnant women were extracted retrospe...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=4;spage=491;epage=496;aulast=Mahalakshmi |
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| author | Manni Mohanraj Mahalakshmi Balaji Bhavadharini Kumar Maheswari Gunasekaran Kalaiyarasi Ranjit Mohan Anjana Unnikrishnan Ranjit Viswanathan Mohan Kurian Joseph Kurian Rekha Sivagnanam Nallaperumal Belma Malanda Arivudainambi Kayal Anne Belton Ram Uma |
| author_facet | Manni Mohanraj Mahalakshmi Balaji Bhavadharini Kumar Maheswari Gunasekaran Kalaiyarasi Ranjit Mohan Anjana Unnikrishnan Ranjit Viswanathan Mohan Kurian Joseph Kurian Rekha Sivagnanam Nallaperumal Belma Malanda Arivudainambi Kayal Anne Belton Ram Uma |
| author_sort | Manni Mohanraj Mahalakshmi |
| collection | DOAJ |
| description | Aim: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC).
Materials and Methods: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records.
Results: Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m2 vs. 25.2 ± 5.1 kg/m2; P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone.
Conclusion: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings. |
| first_indexed | 2024-12-21T13:33:48Z |
| format | Article |
| id | doaj.art-04ae0ef6726f44a0b4f0d292ccfc941d |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-21T13:33:48Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-04ae0ef6726f44a0b4f0d292ccfc941d2022-12-21T19:02:13ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102016-01-0120449149610.4103/2230-8210.183469Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3)Manni Mohanraj MahalakshmiBalaji BhavadhariniKumar MaheswariGunasekaran KalaiyarasiRanjit Mohan AnjanaUnnikrishnan RanjitViswanathan MohanKurian JosephKurian RekhaSivagnanam NallaperumalBelma MalandaArivudainambi KayalAnne BeltonRam UmaAim: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). Materials and Methods: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records. Results: Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001) and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m2 vs. 25.2 ± 5.1 kg/m2; P < 0.001). Rates of cesarean section (26.2% vs. 18.7%; P < 0.001), preeclampsia (1.8% vs. 0.8%; P = 0.04), and macrosomia (13.9% vs. 10.8%; P = 0.02) were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001), preeclampsia (0.7% vs. 3.2%; P = 0.015), and macrosomia (9.9% vs. 18.6%; P = 0.0006) were significantly lesser compared to those treated with MNT alone. Conclusion: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings.http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=4;spage=491;epage=496;aulast=MahalakshmiAsian Indiansfetal outcomesgestational diabetes mellitusmaternal outcomesSouth Asians |
| spellingShingle | Manni Mohanraj Mahalakshmi Balaji Bhavadharini Kumar Maheswari Gunasekaran Kalaiyarasi Ranjit Mohan Anjana Unnikrishnan Ranjit Viswanathan Mohan Kurian Joseph Kurian Rekha Sivagnanam Nallaperumal Belma Malanda Arivudainambi Kayal Anne Belton Ram Uma Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) Indian Journal of Endocrinology and Metabolism Asian Indians fetal outcomes gestational diabetes mellitus maternal outcomes South Asians |
| title | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
| title_full | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
| title_fullStr | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
| title_full_unstemmed | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
| title_short | Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3) |
| title_sort | comparison of maternal and fetal outcomes among asian indian pregnant women with or without gestational diabetes mellitus a situational analysis study wings 3 |
| topic | Asian Indians fetal outcomes gestational diabetes mellitus maternal outcomes South Asians |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=4;spage=491;epage=496;aulast=Mahalakshmi |
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