Pregnancy with diabetes: Consequences and need for awareness.

Diabetes mellitus (DM) is a persistent metabolic illness resulting either from insulin deficiency or peripheral tissue resistance. DM makes the most prevalent complication of pregnancy. 

In the early 1990s, pregnancy complicated by overt diabetes suffered horrific mortality and morbidity for the mother and her fetus. With the invention of Insulin, the scenario has changed, yet it remains a formidable pregnancy complication. 

Dixit M et al. investigated the fetomaternal outcome in cases of pregnancy complicated with diabetes. They also explored the measures to combat the outcomes.

They conducted a prospective observational study in a tertiary care center enrolling 70 patients in a period of July-2020 to June- 2021 at Civil Hospital, Ahmedabad, and found increasing gravidity, age, and past history of GDM as the important risk factor for such cases. They noted 44% of patients with polyhydramnios, 8% with uteroplacental insufficiency, and 6% with intrauterine deaths. The researchers also documented the management of 52 patients with Insulin, ten patients with oral antidiabetic agents, and the remaining eight patients with dietary therapy alone. Among the enrolled patients, 48% underwent emergency cesarean section, 28% delivered normally, and 8% of patients needed instrumental vaginal delivery. In the end, 10 cases of pregnancies with diabetes developed hypertension, and 6% of cases had macrosomia. They noted a 32% incidence of Birth weight > 3.5 kg, and most neonates were admitted to NICU for 24 hours of observation. The unfortunate situation of perinatal mortality occurred in 6 cases of pregnancy with diabetes mellitus.

Given the adverse consequences of diabetes, educating patients about regular antenatal care and proper screening is crucial. Universal screening and a team approach is the cornerstone in managing pregnancy with diabetes mellitus. Raising awareness about this condition is important because both mothers and babies are at risk of developing diabetes in the future. Hence they make the ideal group to be targeted for lifestyle modification to delay the onset of overt diabetes.

Dixit M, Kapadia SN, Parmar KG, Pregnancy with diabetes: The study of fetomaternal outcome in a tertiary care teaching centre in western India. Indian J Obstet Gynecol Res. 2023;10(1):12-16