Comparison of Perinatal outcome in pregnant patients with one abnormal value in OGTT as compared to more than two values as per the IADPSG criteria

Background: To study the association of gestational diabetes mellitus and adverse perinatal outcome.Materials and methods: 296 pregnant patients were enrolled in the study and at 24-28 weeks 75 grams OGTT was done and 40 patients were diagnosed as GDM after satisfying the criteria.For comparison the study group was divided in to two groups.Group 1 which included the patients which had only one abnormal value in OGTT, Group 2 which included patients with ≥ 2 abnormal values in OGTT.All these patients were followed till post delivery for perinatal outcome in terms of birth weight, neonatal hypoglycaemia, hyperinsulinemia using cord blood serum C -peptide levels, caesarean delivery for CPD, respiratory distress syndrome, birth trauma, shoulder dystocia and perinatal mortality.Results: In the study group 15 babies out of 40(37.5%)were LGA (large for gestational age).In group 1, 6 out of 20 babies (30%) were LGA whereas in group 2, 9 out of 20 babies (45%) were LGA.6 out of 40 babies (15%) had hypoglycemia.In group 1 the incidence of hypoglycemia was 2 in 20 (10%) and in group 2 it was 4 in 20 (20%).The mean cord blood C-peptide level in this study was 2.12±2.17and elevated levels were seen in 11 out of 40 patients (27.5%).In group 1, it was in 4out of 20 cases (20%) and 7 out of 20 cases (35%) in group 2. Birth injury was seen in 1 baby, 2 had asphyxia and 4 had respiratory distress.Hypocalcaemia, hyperbillirubinemia, polycythemia, sepsis and NICU admission were seen in 5,6,6,3 and 6 babies respectively, neonatal mortality in none. Conclusion: Adverse perinatal outcome includingLGA babies were encountered with lower threshold cut-offs and single deranged value of blood sugars , in particular with fasting blood sugar values.