Maternal Outcome in Diabetic Pregnant Women-Impact of an Intervention Programme
Abstract
Gestational diabetes mellitus is a substantial and growing health concern. It has serious, long term consequences for both baby and mother. Early detection and intervention can greatly improve outcomes for women with this condition. Studies have revealed higher incidence of preterm labor, pre-eclampsia, nephropathy, birth trauma, caesarean section, postoperative wound complications, fetal wastage from early pregnancy loss or congenital anomalies, macrosomia, shoulder dystocia, stillbirth, growth restriction, and hypoglycaemia etc. Therefore the present study using quasi-experimental time series non-equivalent control group design was conducted on 110 sample subjects, 56 in experimental group and 54 in control group, in a selected hospital of Kashmir (J&K, India) to determine the effectiveness of antenatal intervention on maternal parameters of diabetic pregnant women in order to improve their outcome. The study revealed a significant difference in maternal outcome of experimental group of diabetic pregnant women as compared to control group of diabetic pregnant women.
References
Dutta DC. Text Book of Obstetrics. 6th ed, Calcutta: New central Book Agency; 2004.
Meyer BA, SM Palmer. Pregestational diabetes. Semin Perinatol 1990; 14(1): 12.
Schwartz R, Temaro KA. Effects of diabetic pregnancy on the fetus and newborn. Seminars in perinatology
; 24(2): 120-135.
Reece EA, Homko C, Miodovnik M et al. A consensus report of the diabetes in pregnancy study group of
North America Conference, Little Rock, Arkansa, May, 2002.Matern Fetal Neonatal Medicine 2002; 12: 362-
American Diabetic Association. Gestational Diabetes care. 2003;26: S103-S105.
Langer O, Yogev Y, Most O et al. Gestational diabetes: the consequences of not treating. Am J Obstet Gynaecol
; 192: 989-997.
Greco P, Loverro G, Selvaggi L et al. Does gestational diabetes represent an obstetrical risk factor?
Gynaecology Obstetric Investigations 1994; 37(3): 242-245.
Growther CA. Effect of treatment on pregnancy outcome. N Eng Jounal of Medicine 2005; 352: 2477-
Hare JW. Gestational diabetes mellitus: levels of glycaemia as management goals. Diabetes. 1991; 40:
-196.
Dempsey JC, Butler CL, Sorensen TK et al. A case control study of maternal recreational physical activity and risk of gestational diabetes. Diabetes Research and Clinialc
Practice 2004; 66(2): 203-215.
Gribble RK, Meier PR, Berg RL. The value of urine screening for glucose at each prenatal visit. Obstetrics
Gynaecology. 1995; 86(3): 405-410.
Major CA, Henry MJ, De Veciana M etal. The effects of carbohydrate restriction in patients with diet-controlled
gestational diabetes. Obstet Gynaecol 1998; 91: 600-604.
Wang Thomas W. American Family Physician. Exercise during pregnancy. www.aafp.org./afp/980415ap/wang/html. 2011.
Lewis Beth. The effect of exercise during pregnancy on maternal outcome: practical implication for practice.
Am J Lifestyle Medicine 2008; 2(5): 441-445.
Jacob Annamma. A Comprehensive textbook of Midwifery and Gynaecological Nursing. 3rded. New
Delhi: JP Brothers 2012.
Di Simone N, Ronsisvalle E, Fulghesu AM etal. Insulin plasma levels in pregnant patients with impaired
glucose tolerance: relationship with pregnancy outcome. Gynaecology Obstetric Investigations 1996;
(1): 16-20.
Caruso A, Di Simone N, Ronsisvalle E etal. Insulin secretion in patients with gestational diabetes andits relationship with pregnancy outcome. Hormone Research 1998; 41(5-6): 205-208.
Coetzee EJ and Levitt NS. Maternal diabetes and neonatal outcome. Semin Neonatal. 200; 5(3): 221-229.
Catalano PM, Roman NM, Tyzbir ED etal. Weight gain in women with gestational diabetes. Obstetr Gynaecol
; 81(4): 523-528.
Fraser D, Weitzman S, Leiberman JR etal. Gestational diabetes among Bedouins in Southern Israel:
comparison of prevalence and neonatal outcome with the Jewish population. Acta Diabeto. 1994; 31
(2): 78-81.
Hawthorne G, Snodgrass A, Tunbridge M et al. Outcome of diabetic pregnancy: an adult of fetal loss in New
Castle General Hospital. Diabetic Research Clinical Practices 1994; 25(3): 189-190.
Gazzolo D, Scopesi F, Russo A etal. Doppler velocimetry and behavioural state development in relation to
perinatal outcome in pregnancies complicated by gestational diabetes. Early Human Development. 1995;
(3): 193-201.
China YT. Gestational Diabetes: obstetric and neonatal outcome. Singapore Medical Journal. 2006; 37(6):
-594.
Dutta DC. Effect of diabetes during pregnancy and perinatal and neonatal outcome. J Obstetr and Gynaecol
; 52: 18-20.
Crowther CA, Hiller JE, Moss JR et al. Effect of Treatment of Gestational Diabetes Mellitus on
Pregnancy Outcomes. N England J Med 2005; 352: 2477-2486.http://www.nejm.org/doi/full/10.1056/ nejmoa042973.
Rosenberg TJ, Garbers S, Lipkind H etal. Maternal obesity and diabetes as risk factors for adverse pregnancy
outcomes: differences among 4 racial/ ethnic groups. Am J Public Health 2005; 95(9): 1545-1551.
Langer O, Yogev Y, Xenakis EM et al. Overweight and obese in gestational diabetes: the impact on pregnancy
outcome. Am J of Obstetr & Gynecol 2005; 192(6): 1768-1776.
Bell R, Bailey K, Cresswell T etal. Trends in prevalence and outcome of pregnancy in women with pre-existing
type II diabetes mellitus. BJOG 2008; 115(4): 445-452.
GarcÃa-Patterson A, MartÃn E, Ubeda J etal. Evaluation of light exercise in the treatment of gestational diabetes. Diabetes Care 2001; 24: 2006-2007.
Metzger BE Buchanan TA, Coustan DR etal. Summary and recommendations of the fifth international
workshop-Conference on gestational diabetes mellitus. Diabetes Care 2007; 30: S251-260.
Mattoo CK. A study to evaluate the effectiveness of planned health education programme on knowledge,
skill, stress and glycaemia levels and maternal and neonatal outcome of mothers with gestational diabetes.
Doctor of Philosphy: University of Delhi, 2007.
Malik SJ, NA Mir. Perinatal mortality in high risk pregnancy: a prospective study of preventable factors. J Obsterics and Gynaecol of India 1992; 18(1): 45-48.
Amin S, Ali I. Influence of various epidemiological correlates on nutritional status of pregnant women.
JK Practitioner 2001; 8(1):
Spong Cathy. Evaluating the data-NICHD Research on pregnancy and weight. http://www.starthealt
hystayhealthy.
Thangaratinam S, Rogozinska E, Jolly K etal. Effects of interventions in pregnancy on maternal weight
and obstetric outcomes: meta-analysis of randomized evidence. BMJ 2012; 344e: 2088. htpp://www.bmj.
com/content/344/bmj.e2088.
Rehana K. Pregnancy weight gain patterns and its relationship with various sociomedical factors and
perinatal outcome. Unpublished MD Thesis: Deemed University, SKIMS, Srinagar, 1999.
Simona Bo, Menato G, Villois P et al. Iron Supplementation and gestational diabetes in
midpregnancy. AJOG 2009; 2001(2): 158-160.
Mathews Z, Mahendra S etal. Antenatal care, care seeking and morbidity in rural Karnataka, India: results
of prospective study. Asia pacific Popl Journal 2001; 16(2): 11-28.
Kramer MS, SW Mc Donald. Aerobic exercise for women during pregnancy. Cochrane Database of Systematic
Reviews 2006 (3): CD000180. DOI;1002/14651858. CD 000180.pub2.
Chandra, Agarwal. Nutritional aspects of women with special reference to pregnancy and lactation period.
Swasth Hind 1986; 7.
Gupta P, Gupta R, Zafar A etal. Control of anaemia among pregnant women by iron supplementation. Ind
J Pub Health 2003; 27(1): 28-30.
Siega-Riz, Maria A, Vishwanathan M, Moss MK etal. A Systematic review of maternal weight gain according
to the Institute of Medicine Recommendations: birth weight, fetal growth and postpartum weight retention.
AJOG. 2009; 201(4): 339-342.
Berkowitz GS, Roman SH, Lapinski RH etal. Maternal characteristics, neonatal outcome and time of diagnosis
of gestational diabetes. Am J Obstetr and Gynaecol 2002; 167: 976-982.
Carr DB, Newton KM, Utzschneider KM etal. Preeclampsia and risk of developing subsequent diabetes. Hypertens pregnancy 2009; 28: 1-13.
Johnson J, Clifton RG, Roberts JM et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines (IOM). Obstetr Gynaecol 2013; 121(5): 969-975.
