Antenatal Risk Factors and Delivery Profiles among Women with Gestational and Pre-Gestational Diabetes

Background: Diabetes in pregnancy, whether pre-gestational or gestational, is associated with significant maternal and perinatal complications. This study aimed to compare maternal and neonatal outcomes among non-diabetic, pre-gestational diabetic, and gestational diabetic pregnancies. Methods: This prospective cross-sectional observational study was conducted among pregnant women with pre-existing diabetes mellitus (PDM), gestational diabetes mellitus (GDM), and non-diabetic pregnant women from January 2004 to December 2005 in the Department of Obstetrics and Gynaecology at Bangabandhu Sheikh Mujib Medical University (BSMMU). Results: Family history of diabetes was significantly higher in pre-gestational (80%) and gestational diabetic groups (88%) compared to non-diabetics (0%). Pregnancy complications such as urinary tract infections (26% in pre-GDM, 30% in GDM) and hypertensive disorders were more common among diabetic pregnancies. Preterm delivery occurred more frequently in pre-GDM (18%) and GDM (14%) compared to non-diabetics (4%). Congenital malformations were noted in 4% of pre-GDM and GDM pregnancies. Mean fasting blood glucose and 2-hour postprandial glucose levels were significantly higher in diabetic groups compared to non-diabetic pregnancies (p<0.001). Gestational age at delivery was lower in diabetic mothers (35.50 ± 4.08 weeks in pre-GDM and 36.34 ± 4.55 weeks) than in non-diabetic mothers (38.98 ± 1.35 weeks). Conclusion: Diabetes during pregnancy, both pre-gestational and gestational, is associated with higher maternal and neonatal complications compared to non-diabetic pregnancies. Early diagnosis, effective glycemic control, and multidisciplinary management are essential to improve outcomes.