The Impact of Undetected Hyperglycaemia During Pregnancy on Maternal and Neonatal Outcomes.

Abstract

Background: Despite clear diagnostic criteria for hyperglycaemia first detected in pregnancy, many pregnant women do not have the proper diagnosis. The following paper analyses the course of the perinatal period in pregnant women with undetected hyperglycaemia and their newborns.

Materials and methods: Medical data of patients hospitalized in the Department of Perinatology between 2020 and 2022 was verified: 1st group: 40 patients with undetected hyperglycaemia, 2nd group: 40 with the diagnosis of gestational diabetes during pregnancy and adequate therapeutic management. The course of the perinatal period, abnormalities in the oral glucose tolerance test (OGTT) and the compliance with recommended postpartum tests were analysed.

Results: There were significant differences in the newborn weights (p=0.039) - in the 1st group 15% large for gestational age (LGA) vs. 0% in the 2nd, and the occurrence of neonatal hyperbilirubinemia requiring phototherapy (p=0.007) - 22.5% in the 1^st group vs. 2.5% in the 2^nd. The most common mistake in the OGTT was evaluation of fasting plasma glucose. In the 1^st group, no effect on incidence of hypertensive disorders, time or the route of delivery was observed. 75% from the 1^st group and 36% from the 2^nd did not perform postpartum OGTT (p=0.003).

Conclusion: Hyperglycaemia in pregnancy is often undetected, which has a negative impact, especially on the neonates. In our study, LGA and hyperbilirubinaemia were significantly more common in neonates of mothers with undetected hyperglycaemia. These women had significantly more careless attitude to the postpartum diagnostic, which may influence future health and course of subsequent pregnancies. New and more effective methods of educating practitioners need to be implemented.