Outcome of pregnancy among malaysian women with diabetes mellitus - A single centre experience

Nirmala @ Chandralega Kampan, Hanis Azman, Izzat Hafiz, Hazwani Mohammad, Chuah Su Yee, Nur Azurah Abdul Ghani, Nor Azlin Mohamed Ismail, Zaleha Abdullah Mahdy

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Abstract

To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25%) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75%) were GDM on insulin and 16 (4%) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p <0.001). Approximately one-third of diabetic woman had no antecedent risk factor. About half of the women with diabetes (n=205, 51.3%) had unplanned pregnancy. Women with DM had greater risk of having spontaneous miscarriage and caesarean section (OR 1.4, 95% CI (1.2-1.7), OR 1.3, 95% CI (1.1- 1.5) respectively). Women with diabetes on insulin had higher risk of preterm delivery and caesarean delivery as compared to those with diet control, (OR 1.7, 95% CI (1.2- 2.5), OR 2.5, 95% CI (1.6-4.1) respectively). The incidence of macrosomia, low Apgar score, need for NICU admission, hypoglycaemia and respiratory distress syndrome (RDS) were higher among women with diabetes as compared to healthy control, and especially in those on insulin. Women with higher HbA1c had significantly increased need for caesarean section and NICU admission with higher incidence of macrosomia and RDS. The overall outcome of women with diabetes especially with higher level HbA1c remained poor as compared to a normal pregnancy.

Original languageEnglish
JournalMalaysian Journal of Public Health Medicine
Volume13
Issue number2
Publication statusPublished - 2013

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Pregnancy Outcome
Diabetes Mellitus
Gestational Diabetes
Insulin
Cesarean Section
Unplanned Pregnancy
Diet
Pregnancy
Apgar Score
Incidence
Spontaneous Abortion
Hypoglycemia
Case-Control Studies
Body Mass Index
Research Design
Mothers

Keywords

  • Complication
  • Diabetes mellitus
  • Gestational diabetes mellitus
  • Maternal and neonatal morbidity
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Outcome of pregnancy among malaysian women with diabetes mellitus - A single centre experience",
abstract = "To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25{\%}) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75{\%}) were GDM on insulin and 16 (4{\%}) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p <0.001). Approximately one-third of diabetic woman had no antecedent risk factor. About half of the women with diabetes (n=205, 51.3{\%}) had unplanned pregnancy. Women with DM had greater risk of having spontaneous miscarriage and caesarean section (OR 1.4, 95{\%} CI (1.2-1.7), OR 1.3, 95{\%} CI (1.1- 1.5) respectively). Women with diabetes on insulin had higher risk of preterm delivery and caesarean delivery as compared to those with diet control, (OR 1.7, 95{\%} CI (1.2- 2.5), OR 2.5, 95{\%} CI (1.6-4.1) respectively). The incidence of macrosomia, low Apgar score, need for NICU admission, hypoglycaemia and respiratory distress syndrome (RDS) were higher among women with diabetes as compared to healthy control, and especially in those on insulin. Women with higher HbA1c had significantly increased need for caesarean section and NICU admission with higher incidence of macrosomia and RDS. The overall outcome of women with diabetes especially with higher level HbA1c remained poor as compared to a normal pregnancy.",
keywords = "Complication, Diabetes mellitus, Gestational diabetes mellitus, Maternal and neonatal morbidity, Type 2 diabetes mellitus",
author = "Kampan, {Nirmala @ Chandralega} and Hanis Azman and Izzat Hafiz and Hazwani Mohammad and Yee, {Chuah Su} and {Abdul Ghani}, {Nur Azurah} and {Mohamed Ismail}, {Nor Azlin} and {Abdullah Mahdy}, Zaleha",
year = "2013",
language = "English",
volume = "13",
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T1 - Outcome of pregnancy among malaysian women with diabetes mellitus - A single centre experience

AU - Kampan, Nirmala @ Chandralega

AU - Azman, Hanis

AU - Hafiz, Izzat

AU - Mohammad, Hazwani

AU - Yee, Chuah Su

AU - Abdul Ghani, Nur Azurah

AU - Mohamed Ismail, Nor Azlin

AU - Abdullah Mahdy, Zaleha

PY - 2013

Y1 - 2013

N2 - To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25%) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75%) were GDM on insulin and 16 (4%) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p <0.001). Approximately one-third of diabetic woman had no antecedent risk factor. About half of the women with diabetes (n=205, 51.3%) had unplanned pregnancy. Women with DM had greater risk of having spontaneous miscarriage and caesarean section (OR 1.4, 95% CI (1.2-1.7), OR 1.3, 95% CI (1.1- 1.5) respectively). Women with diabetes on insulin had higher risk of preterm delivery and caesarean delivery as compared to those with diet control, (OR 1.7, 95% CI (1.2- 2.5), OR 2.5, 95% CI (1.6-4.1) respectively). The incidence of macrosomia, low Apgar score, need for NICU admission, hypoglycaemia and respiratory distress syndrome (RDS) were higher among women with diabetes as compared to healthy control, and especially in those on insulin. Women with higher HbA1c had significantly increased need for caesarean section and NICU admission with higher incidence of macrosomia and RDS. The overall outcome of women with diabetes especially with higher level HbA1c remained poor as compared to a normal pregnancy.

AB - To observe the maternal and neonatal outcomes among women with diabetes mellitus in pregnancy as compared to healthy control. A case-control study involving 400 women with DM who delivered between 2005 to 2009 was done with age-matched control group. A total of 305 women (76.25%) were gestational diabetes mellitus (GDM) on diet control, 79 (19.75%) were GDM on insulin and 16 (4%) were pre-existing DM. The mean body mass index of the women with diabetes was higher compared to the age-matched healthy women (p <0.001). Approximately one-third of diabetic woman had no antecedent risk factor. About half of the women with diabetes (n=205, 51.3%) had unplanned pregnancy. Women with DM had greater risk of having spontaneous miscarriage and caesarean section (OR 1.4, 95% CI (1.2-1.7), OR 1.3, 95% CI (1.1- 1.5) respectively). Women with diabetes on insulin had higher risk of preterm delivery and caesarean delivery as compared to those with diet control, (OR 1.7, 95% CI (1.2- 2.5), OR 2.5, 95% CI (1.6-4.1) respectively). The incidence of macrosomia, low Apgar score, need for NICU admission, hypoglycaemia and respiratory distress syndrome (RDS) were higher among women with diabetes as compared to healthy control, and especially in those on insulin. Women with higher HbA1c had significantly increased need for caesarean section and NICU admission with higher incidence of macrosomia and RDS. The overall outcome of women with diabetes especially with higher level HbA1c remained poor as compared to a normal pregnancy.

KW - Complication

KW - Diabetes mellitus

KW - Gestational diabetes mellitus

KW - Maternal and neonatal morbidity

KW - Type 2 diabetes mellitus

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AN - SCOPUS:84893492883

VL - 13

JO - Malaysian Journal of Public Health Medicine

JF - Malaysian Journal of Public Health Medicine

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