Hyperglycemia in pregnancy among South Asian women: A single tertiary care center experience from Colombo, Sri Lanka.

Asanka Jayawardane, Malitha Patabendige, Dulani Samaranayake, Medini Boteju, Shamalka Dahanayake, Ruvini Perera, Sumudu Jayasinghe, Dakshila Galappatti, C N Wijeyaratne

Journal: Diabetes research and clinical practice 2019;145():138-145

PMID: 29526683

Full Text on Elsevier Science View on PubMed

Abstract

AIM

To study case mix, risk factors, adverse outcomes and associations of hyperglycemia in pregnancy in a cohort of Sri Lankans.

METHODS

Prospective observational study, from April 2011-October 2015 at a tertiary care referral center, Colombo, Sri Lanka. Data from first trimester to delivery of HIP was analyzed. Three subgroups were defined: Diabetes in pregnancy (DIP), Hyperglycemia in early Pregnancy (HIEP) [<24 weeks] and Gestational diabetes (GDM) [>24 weeks].

RESULTS

Of 782 patients 572 (73.1%) had complete data. Case-mix: 137(24.0%) DIP, 331(57.9%) GDM and 104 (18.2%) HIEP. Primigravidae commoner in GDM (<0.05). DIP older - mean 33.3 ± 5.5 years (<0.01). Previous GDM commoner and pharmacological interventions needed in DIP and HIEP. Majority GDM (66.8%) required Medical Nutrition Therapy (MNT) alone. There was no difference in pregnancy outcomes between the 3 subgroups. Macrosomia significantly greater in HIEP (33.7%); neonatal cardiac defects more in DIP and HIEP.

CONCLUSIONS

Increasing maternal age is a significant risk for DIP, while previous GDM is a risk for DIP and HIEP and neonatal congenital cardiac defects in subsequent pregnancies of South Asian women. We recommend preconception screening for glucose intolerance and achieving normoglycaemia among South Asian women with advanced maternal age and previous GDM.

Address: Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Sri Lanka. Electronic address: [email protected].; University Unit of Obstetrics and Gynaecology, Teaching Hospital, Mahamodara, Galle, Sri Lanka.; Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Sri Lanka.

DOI: 10.1016/j.diabres.2018.02.029