Poster Presentation International Association of the Diabetes and Pregnancy Study Groups 2022 - Hosted by ADIPS

Maternal characteristics and pregnancy outcomes of women diagnosed with gestational diabetes at an early oral glucose test (#121)

Alisha Panambalana 1 , Mike Lin 1 , Shailja Tewari 2
  1. Concord Repatriation General Hospital, Concord, NSW, Australia
  2. The Canterbury Hospital, Canterbury , NSW, Australia

 

Aim

To identify the baseline characteristics and pregnancy outcomes of women who were diagnosed with gestational diabetes (GDM) on an early oral glucose test (OGTT) at <24 weeks gestation compared to those diagnosed on routine OGTT at 24-28 weeks’ gestation.  

Research design and methods

Women who attended the GDM clinic at The Canterbury Hospital (TCH) over a 12-month period (June 1st 2020 to June 1st 2021) were evaluated in this retrospective audit. They were categorised as diagnosed on an early OGTT (<24 weeks) or standard OGTT (24-28 weeks). Statistical analysis was performed using SPSS.

Results

383 women were included in the audit with 184 diagnosed on early OGTT and 199 diagnosed on standard OGTT. Compared to standard OGTT, women with an early OGTT were more likely to be older (32.23 ± 0.39 years vs 30.51 ± 0.32 years), of a higher gravida (2.77 ± 0.13 vs 2.36 ± 0.10) and have a higher pre-pregnancy BMI (28.2 ± 0.44 vs 26.57 ± 0.41). They were also more likely to come from a high-risk ethnicity (85.87% vs 76.38%), have previous GDM (42.93% vs 20.10%) and have a positive family history (64.67% vs 53.27%) (all p<0.05).

Hba1c (5.09 ± 0.03 vs 5.00 ± 0.03) and 1hr OGTT (10.30 ± 0.12 vs 9.892 ± 0.10) readings were also higher in women diagnosed on an early OGTT (p<0.05).

Women diagnosed at an early OGTT were more likely to require insulin (71.74% vs 52.76%) and metformin (10.33% vs 3.02%), and less likely to be diet controlled (27.17% vs 46.23%) (all p<0.05).

Respiratory distress in newborns was more common in women who had an early OGTT (11.96% vs 5.03%) (p=0.01). All other pregnancy complications including macrosomia, small for gestational age and NICU admissions were comparable between the 2 groups.

Conclusions

From this retrospective audit we were able to conclude that early GDM is highly prevalent, as the diagnosis was made in approximately half of the pregnant women. These women also had the established risk factors associated with GDM. In women diagnosed with early GDM, despite standard treatment approaches and a greater use of pharmacotherapy, poorer foetal outcomes were noted. These findings suggest the need for further research into the management of these women to improve pregnancy outcomes.