Comparison of obstetric and perinatal outcomes in women with diabetes at Steve Biko Academic Hospital

Abstract

BACKGROUND : Diabetes and obesity in pregnancy have been associated with increased rates of adverse maternal and neonatal outcomes compared with women with normoglycaemia and normal weight. OBJECTIVE : To investigate the effect of diabetes and pre-pregnancy obesity on obstetric and perinatal outcomes. METHODS : This study included women with pregestational diabetes types 1 (T1DM) and 2 (T2DM), gestational diabetes (GDM) and normoglycaemia, who received care at the Steve Biko Academic Hospital antenatal clinic between 2017 and 2022. The women were followed up until delivery. Data collected included obstetric history and care, diabetes, obstetric and perinatal outcomes. RESULTS : A total of 183 women were recruited: 13 (7.1%) with T1DM, 65 (35.5%) with T2DM, 39 (21.3%) with GDM and 66 (36.1%) normoglycaemic controls. Women with T2DM and GDM were older (p<0.01) and more likely to have a history of chronic hypertension (p=0.025) compared with controls. Women with GDM were more likely to be obese than their T1DM counterparts (p=0.036). T1DM and T2DM were associated with higher rates of preterm delivery than controls (p=0.002). The frequency of GDM was significantly higher in women with obesity (p=0.039). The frequency of caesarean section before the onset of labour was higher in women with a weight ≥80 kg compared with women with a weight <80 kg (p=0.015). CONCLUSION : Diabetes in pregnancy is associated with adverse obstetric and perinatal outcomes. Therefore, adequate glucose control should be accompanied by preconceptual weight optimisation to reduce adverse outcomes during pregnancy.