COMPARISON OF FETAL OUTCOME IN PATIENTS WITH VERSUS WITHOUT GESTATIONAL DIABETES MELLITUS IN TERMS OF MACROSOMIA

Abstract

Background: There is ongoing debate in the literature regarding the impact of gestational diabetes mellitus (GDM) on fetal macrosomia. To address this inconsistency, the present study was designed to compare fetal outcomes between women with and without GDM, with a particular focus on assessing the incidence and risk of macrosomia.

Objectives: To determine the association between gestational diabetes mellitus and macrosomia.

Duration: Six months w.e.f 01-08-2024 to 31-01-2025

Methodology:  After ethical approval, 160 pregnant women meeting inclusion criteria at CMH Sialkot were enrolled with informed consent. They underwent a 75g oral glucose tolerance test to diagnose GDM. Based on results, 160 women were divided equally into GDM and non-GDM groups. All participants were followed until delivery and study outcomes were recorded. Deliveries were managed by the same senior consultant to minimize bias, and confounding variables were controlled through strict exclusion criteria. Data collection was performed by the resident to ensure consistency and accuracy.

Results: A total of 160 pregnant women (mean age 28.84 ± 4.75 years) were studied, with 64.4% overweight/obese. Cesarean section was more frequent in the GDM group (47.5%). Neonates of GDM mothers had higher birth weight and significantly greater macrosomia risk (28.7% vs. 13.8%, OR=2.53), consistent across age, BMI, parity, and gestational age subgroups.

Conclusion: In this study, gestational diabetes mellitus was associated with significantly higher neonatal birth weight and increased risk of macrosomia. Although differences in mode of delivery and subgroup analyses were not statistically significant, odds ratios consistently favored a higher risk in GDM cases, highlighting its impact on adverse fetal outcomes.