FETAL-OUTCOME IN GESTATIONAL DIABETES IN SOUTH INDIANS

The study was performed to reassess the prevalence of gestational diab etes mellitus (GDM) in south Indians and to study the foetal outcome i n women with GDM in comparison with normal pregnancies. In 1036 pregna nt women, glucose tolerance was tested with 75-g oral glucose load, in the second or third trimester. Those with 2-h plasma glucose of great er than or equal to 200 mg/dl were considered as diabetic (WHO Criteri a). Those with 2-h values of 140-199 underwent a 3-h glucose tolerance test (GTT) with 100-g glucose load (O'Sullivan and Mahan criteria). G DM was diagnosed in nine women (0.87%) by this criteria. Foetal outcom e in 211 GDM referred to the diabetes centre was compared with the out come in 853 normal pregnancies. There were no cases of aborted pregnan cy among the GDM, while six cases were reported among the normal gluco se tolerance (NGT). Still birth and the number of premature babies wer e higher in GDM, Babies with birth weight greater than or equal to 3.5 kg were more among the GDM (P < 0.001). There was no difference in th e occurrence of congenital anomalies in the two groups. It was noted t hat congenital abnormalities in the foetus were more common among thos e born of mothers with higher plasma glucose (9 versus 1.1%). Multiple linear regression analyses in NGT and GDM showed that the birth weigh t of the baby was dependent on the plasma glucose and the body mass in dex of the mothers. The results of the present study show that the pre valence of GDM in urban south India was low, when the NDDG criteria wa s used. It also indicated that the WHO criteria may be more appropriat e as the foetal outcome was determined by even a small rise in materna l plasma glucose. With good metabolic control in GDM, the foetal risks are very much reduced. (C) 1998 Elsevier Science Ireland Ltd. All rig hts reserved.