Medizinische Universität Graz - Research portal
Selected Publication:
Lanznaster, J.
Maternal and fetal parameters indicative for glycemic control in gestational diabetes
[ Diplomarbeit ] Medical University of Graz; 2010. pp. 103
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- Authors Med Uni Graz:
- Advisor:
- Haas Josef
- Holzapfel-Bauer Margit
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- Abstract:
- Introduction: Gestational diabetes mellitus has been defined as carbohydrate intolerance with onset or first recognition during pregnancy. According to the severity of glucose intolerance, a diet or insulin therapy (White A1 and White A2) should be initiated. The adequate therapy for gestational diabetes protects fetus from diabetic fetopathy in newborn babies from adaptation problems, macrosomia, unripeness of organs and hypoglycaemia. In order to assess the quality of diabetic care in pregnancy, it is necessary to measure cord blood insulin levels. The main aim of this study was to detect diabetic and non-diabetic maternal and fetal parameters, which may serve as predictors for a poor carbohydrate metabolism in pregnancy and therefore may increase the risk for the fetus. Methods: For the scope of this paper, 451 pregnant women affected by gestational diabetes mellitus were retrospectively recruited during the period between April 2003 and April 2009. Results: A total of 82 % of pregnant women were treated with diet (White A1) and 18 % with insulin (White A2). Patients treated with insulin therapy had significantly higher maternal age (p=0.002), weight (in the preconception period as well as at the end of pregnancy p=0.001 and 0,029), BMI (in the preconception period as well as at the end of pregnancy p=0,000 and 0.005), parity (p=0.012), fasting blood glucose levels (p=0.000), operative delivery rates (p=0.049) and cord blood levels for insulin (p=0.000), fructosamine (p=0.005) and C-peptide (p=0.002). Newborns from mothers who received insulin therapy had a lower mean birth weight (p=0.034). Amnion fluid insulin compared to cord blood insulin showed a significant variation in diet treated women (p=0.028). Maternal age, parity, preconception weight/BMI and fasting glucose levels at oGTT should be taken into consideration at initiation of therapy for gestational diabetes. Regular and consistent attendance coupled with an adequate therapy adjustment for women affected by gestational diabetes is important in order to improve neonatal outcome.