The Influence of Gestational Diabetes Mellitus Diagnosis Trimester on Maternal-Fetal Outcomes

Abstract

Gestational Diabetes Mellitus (GDM) is defined as a carbohydrate intolerance that results in hyperglycemia of varying severity with onset or first recognition during pregnancy. It is known that this intolerance, which can appear from the early stage to the end of pregnancy, can cause several maternal-fetal complications during pregnancy, delivery and postpartum. Our objective was to compare maternal-fetal outcomes according to whether the diagnosis of gestational diabetes mellitus was made in the first or second trimester of pregnancy. For this purpose, a retrospective study was conducted with a consecutive sample of 194 pregnant women followed in the gestational diabetes mellitus appointment at Hospital da Senhora da Oliveira -Guimaraes. This analysis showed that there are statistically significant associations between gestational diabetes mellitus diagnosis trimester and the variables obesity and maternal comorbidities. On the other hand, no differences with statistical meaning were found regarding maternal age or used therapy when comparing cases of diagnosis made in the first and second trimesters. Regarding maternal-fetal outcomes, there are no significant associations between the different variables (preeclampsia, onset of labor, oxytocic acceleration, type of delivery, labor instrumentation, prematurity, newborn hospitalization time, macrosomia, hyperbilirubinemia, hypoglycemia and the postpartum reclassification of glycemic status) with the diagnosis trimester. We conclude that the trimester in which gestational diabetes mellitus is diagnosed is not a preponderant factor for maternal-fetal outcomes. This study also showed that a BMI<30 kg per m2 appears to be an independent factor, protective against the diagnosis in the first trimester. Other studies addressing this issue will be necessary to validate these results.