The Impacts of Gestational Diabetes Mellitus on Infants: A Prospective Case-control Study.

Abstract

Background: Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of variable degree with onset or first recognition during pregnancy. GDM is the most common medical complication of pregnancy and it is associated with several maternal and fetal complications resulting significant morbidity and mortality. Objective: To investigate the impact of GDM on various aspects of new-born including birth weight, birth length, ponderal index, head circumference, gestational age, delivery method, and overall health Methods: A case-control study was conducted on a sample of 240, divided into two groups: a GDM group (n=120) and a non-GDM group (control group, n=120). Mothers and babies were recruited at the well-baby clinics in Galle district (six MOH areas). Data were collected using medical and health records, clinic cards and an interviewer-administered questionnaire. Results: Infants of the GDM group had higher mean±SD birth weight (3049.50±520.91 g) than non-GDM group (2868.13±380.73 g, p=0.002). Birth length was also higher in GDM (50.98±3.12cm) than non-GDM group (50.20±2.44cm, p=0.031). Ponderal index, head circumference showed no significant differences. GDM group had more macrosomia cases (6 vs. 0, p=0.013). Gestational age was lower in GDM group (265.61±11.12 days) than non-GDM group (269.05±10.69 days, p=0.015). More pre-term deliveries were observed in GDM group (17 vs. 7, p=0.031). No significant association was found between GDM and mode of delivery (2=2.453, p=0.117). GDM group had significantly higher incidences of episiotomies (2=19.902, p=<0.001). Neonatal jaundice (19 vs. 6, p=0.006), heart murmurs (13 vs.1, p=<0.001) and ASD/VSD (10 vs 0, p=0.001) were significantly higher in GDM group. Complication or infections in the first three months were not significantly different between two groups (p=0.098). Conclusions: GDM is associated with higher birth weights and birth lengths in infants, along with an increased risk of pre-term deliveries. GDM is strongly linked to adverse neonatal outcomes, including macrosomia, neonatal jaundice, heart murmurs, and ASD/VSD. Study highlights challenges in controlling blood sugar levels among GDM patients, emphasizing the need for better management and care to improve the health of both mothers and infants.