Dr Mounika Anitha Chintala, Dr Lakshmi Prasad KK, Dr Mythili Ayyagari


Context: Diabetes in pregnancy is increasing and associated with increased risk of complications. There is little data on whether the pregnancy
outcomes have changed over time.
Aim: The aim is to compare rates of pregnancy outcomes between women with preexisting diabetes and gestational diabetes (GDM).
Settings and Design: This was a prospective observational study done in women with preexisting diabetes and GDM.
Methods and Material: Baseline characteristics and medical comorbidities were recorded. Women were counseled regarding life style
modification (LSM) and glycemic goals. Metformin and/or insulin were used accordingly. Maternal outcomes and neonatal outcomes were
Results: Out of 183 subjects who were enrolled, 74 (40 %) were women with preexisting diabetes and 109 (60%) were GDM. More than 50% of
patients required combination of LSM, metformin and insulin in both groups. Pregnancy weight gain was higher in GDM (11.15±3.48) compared
to preexisting diabetes (10.07±3.25; p<0.05). Preterm delivery was more in preexisting diabetes (43.28%) than GDM (25.24%; p=0.01). There
were higher miscarriages in preexisting diabetes compared to GDM (p=0.02) whereas intra uterine deaths were similar in both groups. Prevalence
of PIH was 26.86% in preexisting diabetes and 15.53% in GDM (p=0.08). Caesarean section rate was 89.55% in preexisting diabetes and 87.37%
in GDM. Birth weight was higher in neonates of GDM compared to preexisting diabetes (3.05±0.42 versus 2.88±0.52, p=0.02). There were four
neonates with congenital malformations in preexisting diabetes and none in GDM.
Conclusions: The present study in women with Preexisting Diabetes and GDM showed higher miscarriages and higher preterm deliveries in
preexisting diabetes. There were high rates of caesarean section, reduced macrosomia and lesser congenital malformations in the present study.


Preexisting Diabetes, Gestational Diabetes, Maternal Outcomes, Neonatal Outcomes.

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Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI, et al. Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract. 2004 Nov;66(2):139–45.

Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Prevalence of gestational diabetes mellitus in South India (Tamil Nadu)--a community based study. J Assoc Physicians India. 2008 May;56:329–33.

Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes mellitus & associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res. 2013 Apr 1;137(4):728.

Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care. 2007 Jul;30(7):1920–5.

Jensen DM, Korsholm L, Ovesen P, Beck-Nielsen H, Moelsted-Pedersen L, Westergaard JG, et al. Peri-Conceptional A1C and Risk of Serious Adverse Pregnancy Outcome in 933 Women With Type 1 Diabetes. Diabetes Care. 2009 Jun;32(6):1046–8.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010 Mar;33(3):676–82.

Mackin ST, Nelson SM, Kerssens JJ, Wood R, Wild S, et al. Diabetes and pregnancy: national trends over a 15 year period. Diabetologia. 2018 Jan 11;

Reddy KM, P. LS, Balmuri S, Jagarlamudi A, Betha K. Prevalence of gestational diabetes mellitus and perinatal outcome: a rural tertiary teaching hospital based study. Int J Reprod Contracept Obstet Gynecol. 2017 Jul 26;6(8):3594.

Kumari R, Dalal V, Kachhawa G, Sahoo I, Khadgawat R, Mahey R, et al. Maternal and Perinatal Outcome in Gestational Diabetes Mellitus in a Tertiary Care Hospital in Delhi. Indian J Endocrinol Metab. 2018;22(1):5.

Singh N, Madhu M, Vanamail P, Malik N, Kumar S. Efficacy of metformin in improving glycaemic control & perinatal. INDIAN J MED RES. 2017;6.

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 Apr;60(4):636–44.

Prakash Gt, Das A, Habeebullah S, Bhat V, Shamanna S. Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian J Endocrinol Metab. 2017;21(6):854.

Bhat M, K N R, Sarma SP, Menon S, C V S, S GK. Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in south India. Int J Diabetes Dev Ctries. 2010 Apr;30(2):91–6.

Sreelakshmi PR, Nair S, Soman B, Alex R, Vijayakumar K, Kutty VR. Maternal and neonatal outcomes of gestational diabetes: A retrospective cohort study from Southern India. J Fam Med Prim Care. 2015 Jul 1;4(3):395.

Mahalakshmi MM, Bhavadharini B, Maheswari K, Kalaiyarasi G, Anjana RM, Ranjit U, et al. Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: A situational analysis study (WINGS-3). Indian J Endocrinol Metab. 2016;20(4):491–6.

Wahabi H. Maternal and Perinatal Outcomes of Pregnancies Complicated with Pregestational and Gestational Diabetes Mellitus in Saudi Arabia. J Diabetes Metab [Internet]. 2014 [cited 2018 Apr 11];05(07). Available from:

Ray JG. Maternal and neonatal outcomes in pregestational and gestational diabetes mellitus, and the influence of maternal obesity and weight gain: the DEPOSIT study. QJM. 2001 Jul 1;94(7):347–56.


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