A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Nompumelelo Malaza; Matladi Masete; Sumaiya Adam; Stephanie Dias; Thembeka Nyawo; Carmen Pheiffer

doi:10.3390/ijerph191710846

A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Int J Environ Res Public Health. 2022 Aug 31;19(17):10846. doi: 10.3390/ijerph191710846.

Authors

Nompumelelo Malaza^{1

2}, Matladi Masete^{1

2}, Sumaiya Adam^{2

3}, Stephanie Dias¹, Thembeka Nyawo^{1

4}, Carmen Pheiffer^{1

2

4}

Affiliations

¹ Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa.
² Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
³ Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
⁴ Centre for Cardio-Metabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town 7505, South Africa.

Abstract

Pregestational type 1 (T1DM) and type 2 (T2DM) diabetes mellitus and gestational diabetes mellitus (GDM) are associated with increased rates of adverse maternal and neonatal outcomes. Adverse outcomes are more common in women with pregestational diabetes compared to GDM; although, conflicting results have been reported. This systematic review aims to summarise and synthesise studies that have compared adverse pregnancy outcomes in pregnancies complicated by pregestational diabetes and GDM. Three databases, Pubmed, EBSCOhost and Scopus were searched to identify studies that compared adverse outcomes in pregnancies complicated by pregestational T1DM and T2DM, and GDM. A total of 20 studies met the inclusion criteria and are included in this systematic review. Thirteen pregnancy outcomes including caesarean section, preterm birth, congenital anomalies, pre-eclampsia, neonatal hypoglycaemia, macrosomia, neonatal intensive care unit admission, stillbirth, Apgar score, large for gestational age, induction of labour, respiratory distress syndrome and miscarriages were compared. Findings from this review confirm that pregestational diabetes is associated with more frequent pregnancy complications than GDM. Taken together, this review highlights the risks posed by all types of maternal diabetes and the need to improve care and educate women on the importance of maintaining optimal glycaemic control to mitigate these risks.

Keywords: adverse outcomes; gestational diabetes mellitus; pregnancy; type 1 diabetes mellitus; type 2 diabetes mellitus.

Publication types

Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Cesarean Section
Diabetes Mellitus, Type 1*
Diabetes Mellitus, Type 2*
Diabetes, Gestational* / epidemiology
Female
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome / epidemiology
Premature Birth*

Grants and funding

This work was funded by the National Research Foundation (NRF) Competitive Programme for Rated Researchers Grant No: 120832 to Carmen Pheiffer and the South African Medical Research Council (SAMRC) Research Capacity Development funding Malaza N and Masete M. Baseline funding from the Biomedical Research and Innovation Platform of the SAMRC is also acknowledged. The content here is the sole responsibility of the authors and does not necessarily represent the official views of the NRF or SAMRC.