Gestational Diabetes: Diagnostic Timing and Maternal-Neonatal Outcomes — ASN Events
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  2. Lunch & Poster Session
  3. Gestational Diabetes: Diagnostic Timing and Maternal-Neonatal Outcomes

Gestational Diabetes: Diagnostic Timing and Maternal-Neonatal Outcomes (#144)

Ayesha Ajgaonkar 1 , Alyssa Fan 2 , Jasmine Porter 2 , Calum Reid 2 , Tripti Joshi 3 , Lili Yuen 2 3
  1. School of Rural Medicine, Univeristy of New England, Taree, NSW, Australia
  2. Central Coast Clinical School, The University of Newcastle, Gosford, NSW, Australia
  3. Central Coast Local Health District, Gosford, NSW, Australia

Introduction

Emerging evidence suggests that earlier screening and treatment of gestational diabetes (GDM) improves neonatal and maternal outcomes.1 However, there is little comparison between the outcomes of GDM diagnosis earlier in pregnancy versus the standard diagnosis in real-world settings.

Aim

To compare and examine the maternal and neonatal outcomes in mothers who received an early GDM (4 to 19+6 weeks) versus standard (after 20 weeks) diagnosis, since the implementation of the 2014  Australian Diabetes in Pregnancy (ADIPS) criteria.2

Methods

A retrospective audit was conducted of all GDM pregnancies presenting to the Central Coast Local Health District antenatal clinic between January 2019 to April 2024. GDM was present if oral glucose tolerance test (OGTT) results were consistent with 2014 ADIPS guidelines.2 Maternal characteristics, antenatal treatment, maternal and neonatal outcomes, were obtained from electronic medical records.

Results

A total of 1883 pregnancies were included in the study, comprising 376 (20.0%) early and 1507 (80.0%) standard GDM diagnoses. Women with early GDM were older (32.24% v 31.37%, p=0.004), more likely to have PCOS (20.5% v 12.5%, p<0.001), prior GDM (40.2% v 17.2%, p<0.001), and a family history of diabetes (44.9% v 33.3%, p<0.001) than standard GDM.

Comparing early to standard GDM, for the mother there were significant differences (p<0.001) for rate of insulin treatment (71.0% v 48.3%), spontaneous labour (19.1% v 29.3%), emergency caesarean (25.3% v 17.6%). For the foetus, the gestational age was lower at delivery (38.24±2.5 v 38.76±1.3, p<0.001), they had a lower birthweight (3336±702.9g v 3391±511.6g, p<0.001) and were shorter in length (49.03±7.5 v 49.87±5.0, p<0.001).

Conclusion

Early GDM was associated with greater treatment requirements, increased obstetric intervention, and delivery of smaller neonates compared with standard GDM. Prospectivestudies are required to determine whether early treatment independently improves perinatal outcomes.