Assessment of the Effect of Pre-Gestational Diabetes and Risk of Adverse Maternal, Perinatal and Neonatal Outcomes in Egypt

Abstract

Introduction: Most women with pre-gestational diabetes (PGD) characterized by disturbance in glucose metabolism may be due to variable degrees of insulin resistance (type 2), or a consequence of autoimmune destruction of the pancreatic β-cells (type 1). With increasing numbers type 1 diabetes diagnosed among youth and high prevalence of obesity among women of child-bearing age , the demographic pattern of PGD is changing.Objective: The aim of this work was to assess the effect of pre-gestational diabetes and risk of adverse maternal, prenatal & neonatal outcomes in Alexandria-Egypt.Subjective: This study conducted on 75 patients pregnant with pre-gestational diabetes mellitus in El-Shatby University Hospital. The aim of this work is to assess the effect of pre-gestational diabetes and risk of adverse maternal, prenatal & neonatal outcomes in Alexandria-Egypt.Results: Regarding maternal complications, it was found that 14 patients (18.7%) have pre eclampsia, 8 patients (10.6%) have diabetic ketoacidosis , 5 patients (6.7%) have ICU admission.Regarding the mode of delivery it was found that 63 patients (94%) have caesarian section delivery while 4 patients (6%) have normal vaginal delivery. It was found that 4 patients (6.0%) have postpartum hemorrhage and 10 patients (7.5%) have wound complications after delivery. fetal complications was found that 7 patients (9.3%) have cardiac anomalies and 1 patients (1.4%) has Neural tube defect. 19 patients (33.9%) have Polyhydramnios, And 13 patients (17.3%) have intra uterine fetal Finally 3 patients (4%) have intra uterine growth restriction. Natal complications was found that 2 cases (3.7%) have Prolonged labour, 2 cases (3.7%) have Shoulder dystocia,5 cases (9.3%) have still birth, only 1 case (1.9%) has Erb’s palsy while 9 neonates (16.7%) have neonatal intensive care unit admission. Neonatal complications was found that 16 patients (29.7%) have respiratory distress, 11 neonates (20.4%) have jaundice. 22 neonates (40.7%) have neonatal hypoglycemia.Conclusion: Elevated HbA1C value of the increased risk of congenital fetal malformation especially neural tube defect & cardiac defects. Diabetes plays an increasing role in the number of children born with congenital anomalies.