A COHORT STUDY TO EVALUATE THE EFFECTS OF TYPE 2 DIABETES MELLITUS IN THIRD-TRIMESTER OF PREGNANCY

Background: Diabetes is the most common cause of pregnancy morbidity, and a sedentary lifestyle and family history are the most common contributing factors. Maternal diabetes is linked to poor maternal and newborn outcomes. The goal of this study is to predict the outcomes for both the mother and the fetus in cases of pre-existing type 2 diabetes during the third trimester of pregnancy.

Methods: A tertiary care facility in Central India was studied retrospectively. The research was conducted from March 3, 2022, to May 3, 2022. Women with FBS >126 mg/dl and an HbA1c >6.5 were classified as diabetic, those with FBS between 100 and 125 mg/dl and an HbA1c between 5.7 and 6.4 as pre-diabetic, and those with FBS 100 mg/dl and an HbA1c less than 5.6 as non-diabetic. Prenatal outcomes were assessed for both women and newborns. All of the data was processed using SPSS version 21.0 for Windows (IBM Corp., Armonk, NY).

Results: The study evaluated 190 (33.9%) diabetic and 370 (66.07%) non-diabetic women. In the two groups, adverse maternal outcomes were calculated. In diabetic women, gestational hypertension (68% vs. 25% p: <0.0001), preeclampsia (69% vs. 25% p: <0.0001), antepartum hemorrhage(22% vs. 09% p: =0.0001), postpartum hemorrhage(89% vs. 217% p: <0.0001), prolonged/obstructed labor(54% vs. 20% p: <0.0001), urgent induction of labor(44% vs. 2% p: <0.0001), and urgent caesarean section (CS) (69% vs. 29% p: 0.0001) were significantly more common as compared to non-diabetic women. Adverse neonatal outcomes such as high birth weight >4kgs(HBW) (79% vs. 29% p: <0.0001), preterm delivery (29% vs. 15% p: <0.0001), stillbirth (11% vs. 3% p: 0.001), and early neonatal death (6% vs. 2% p: 0.0001), congenital heart defects (5% vs. 0.2% p: <0.0001), hypoglycemia in newborn (27% vs. 2% p: 0.001) were associated more with diabetes. We did not establish any reports of maternal mortality during the study.

Conclusion: Diabetes mellitus type 2 also hurts maternal and fetal outcomes during the third trimester. Proper blood glucose monitoring and effective control through diet, exercise, and medications are required to avoid such adverse outcomes.