Comparison of pregnancy complications between gestational diabetes mellitus and normal group in Iran: a cohort study

Introduction: To compare the incidence of fetal, maternal and neonatal complications amongst women with gestational diabetes mellitus (GDM) and pregnant women with normal glucose tolerance in Shahrood. Materials and Methods: In order to compare fetal and maternal complications, for all pregnant women who were referred from private clinics and health care settings to Fatemiyeh Hospital for screening of GDM, prenatal care was done in a cohort study. The records of mothers and neonates were obtained from delivery and nursery units. Results: Between GDM group (63 pregnant women) and 1247 pregnant women with normal glucose tolerance, there were significant differences (p<0.001) in the rate of hypertension in pregnancy (9.7% vs. 1.8%), still birth (6.5% vs. 0.4%), hydramnious (8.1% vs.. 0.6%), cesarean section (86.9% vs. 57.6%), and macrosomia (8.1% vs. 2.8%, p<0.05). There was no difference in the rate of pre-eclampsia, pyelonephritis, pre-term delivery, low birth weight, Intra uterine growth retardation, fetal or neonatal malformations, shoulder dystocia and need for resuscitation delivery. There was also no difference in birth weight and other neonatal birth measurements. Among Pregnant women in GDM group who were younger than 25 years and had no risk factors, there was no fetal, maternal and neonatal complications, none of them required insulin therapy in pregnancy and all had normal blood glucose after delivery. Conclusion: Some of the complications were higher in GDM than in normal group, possibly due to poorer glycaemic control. Moreover, according to previous studies, the prevalence of GDM in Iranian pregnant women is comparable with developed countries, so more surveys regarding selective screening and cost effectiveness of universal screening in Iranian population are recommended.