Can We Predict the Sex of Babies and their Outcome in Relation to Gravida of Mother with Trimesteral Glucose in Gdm & Ngdm Persistently Elevated Cases?

Abstract

Introduction: Gestational diabetes mellitus is defined as diabetes diagnosed for the first time during pregnancy and its incidence is 3-7% of pregnancies. There are many risk factors like sex, birth weight of babies. Fetal sex potentially may influence maternal glucose metabolism in pregnancy. Some studies found that higher maternal fasting glucose during 4-12 weeks gestation of pregnancy was associated with more birth weight and birth height. So, despite of tremendous research there is no consensus about universal screening and selective screening for GDM. Treatment of GDM reduces serious perinatal morbidity, improves neonatal outcome. Aim: To find out the correlation between sex and birth weight of babies, time and mode of delivery by gestational age and outcome in relation to gravid of mothers with trimesteral glucose in persistently elevated and confirmed GDM cases. Materials and Methods: A prospective randomised study was done in KIMS Medical College and Hospital, Amlapuram from January 2014 to January 2016, with patients consent and ethical committe approval. It included 150 cases attending in the antenatal clinic of Obstetrics and Gynaecology Department and Hospital delivery in KIMS Medical College. After detailed history and clinical examination, investigation OGTT (Oral Glucose Tolerance Test) in the first trimester of pregnancy was done. Babies delivered from NGDM persistently elevated (PGBS >100mg/dl) and confirmed GDM (Gestational Diabetes mellitus) (PGBS >140mg/dl) cases were admitted with complication in NICU. Results: Most GDM cases (76%) were in the age >30 years in compared to NGDM cases (57.77%). In 20 -25 years of age, majority GDM (80%) were in multi and 64.44% of NGDM persistently elevated in primi cases. Most of cases (50%) delivered after 37 weeks of gestation. The commonest mode of delivery was LSCS in all groups of blood sugar level of 100-120mg/dl,120-140mg/dl and >140mg/dl. In the present study, male babies were predominantly delivered from primi mothers not from multigravida as in other study. Whereas, in NGDM persistently elevated level, babies predominantly delivered from multigravida mothers were male babies. Those mothers who were diagnosed early and undergone treatment delivered term babies, whereas those who were late diagnosed had preterm deliveries. Conclusion: Though, the neonatal complications are poorly predictable by maternal history and risk factors like sex, birth weight of babies especially in nullipara. From this study, it was observed that sex of babies had important effect on mother’s glucose status and early treatment of GDM cases reduces perinatal outcome.

Keywords

• foetal growth restriction (fgr)
• neonatal complications
• post glucose blood sugar (pgbs).