THE MATERNAL AND NEWBORN PROFILES AND OUTCOMES OF PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS GIVEN MEDICAL NUTRITION THERAPY

Authors: AC Balderas, DCS Redondo-Samin, NDV Gundao, CFC De Vera, KC Reyes

Publisher: Clinical Nutrition ESPEN an International Journal Devoted to Clinical Nutrition and Metabolism

Publication Date: MARCH, 2023

URL: https://doi.org/10.1016/j.clnesp.2022.09.164

ABSTRACT:
Rationale: The prevalence of Gestational diabetes mellitus (GDM) is rising in the Philippines with increasing risk of short and long term complications in both mother and newborn. Medical Nutrition Therapy (MNT) remains the cornerstone of treatment and results in improved maternal and neonatal outcomes, especially when diagnosed and treated early. This study aimed to describe the maternal and newborn profiles and outcomes of pregnant women with GDM given medical nutrition therapy.
Methods: Prospective cohort study done among 81 GDM mothers who gave birth at St. Luke’s Medical Center, Quezon City, Philippines. After nutrition screening, mothers were given MNT. Assessment of nutritional adequacy and weight gain is monitored every visit until delivery. Maternal profiles as to age, gravidity, parity, pre-pregnant weight and BMI, gestational age at diagnosis were obtained and outcomes as to gestational age at delivery, delivery route and total weight gained noted. The newborn profiles as to age, sex and birthweight and outcomes as to Gestational age and Birthweight classification, Appropriateness for gestational age, and Neonatal Intensive Care Unit(NICU) admission were determined. Means and standard deviation were computed for continuous variables while numbers and percentages were used for categorical variables.
Results: Among 81 participants with GDM, 66.7% were aged 19-34 years old and 33.3% were 35yo and above. More than half 54.3% have normal pre-pregnant BMI and 44.5% were overweight and obese. Mostly (54.3%) were multigravida and 50.6 % were nulliparous versus primipara & multipara at 49.4%. Majority (53.1%) delivered by lower segment cesarean section 46.9% delivered via vaginal route. The odds of having NICU admission is 51% higher for cesarian delivered babies. There were 81 babies, 59.3% were females and 40.7% were males, with 82.7% term, and 17.3% preterm. Among these, 87.7% had normal birthweight. Almost all neonates were appropriate for gestational age and only 2.5% were large for gestational age. Among these newborns. 37% were admitted in NICU.
Conclusion: In this prospective cohort study, findings confirmed that most GDM mothers deliver via cesarian section. The control of blood glucose without insulin may lower the odds of neonates being admitted in the NICU. Therefore, multidisciplinary treatment of gestational diabetes in the form of dietary advice and individualized MNT, alongside with adequate blood glucose and gestational weight gain monitoring and control, may reduce the rate of NICU admission of neonates.
Disclosure of Interest: None declared