Multi-morbidities, delivery outcomes, and discharge plans of mothers with gestational diabetes mellitus who delivered at Teaching Hospital Jaffna

Abstract

Introduction: Gestational diabetes mellitus (GDM) is common and is often accompanied with other comorbidities. This study was carried out to describe the prevalence of GDM, the presence of multi-morbidities, outcomes, and management on discharge of mothers who delivered their babies at Teaching Hospital Jaffna. Methods: A hospital-based descriptive cross-sectional study was carried out at Teaching Hospital Jaffna using a KoBoCollect-based data extraction form. Secondary data from the Bed Head Tickets (BHT) of mothers who delivered babies between January and June 2023 were extracted. Standard descriptive statistics were applied. Results: BHTs of 3500 mothers were traced; 14.9% (n=523) mothers had GDM. The median age of mothers with GDM was 31.0 (±5.5) years. Among them, 15.5% (n=81), 9.8% (n=51), and 5.7% (n=30) had pregnancy induced hypertension (PIH), anaemia, and thyroid/other disorders, respectively, and seven mothers had both PIH and anemia. Two mothers had all three morbidities along with GDM. Over a quarter (28.1%, n=147) had a family history of diabetes. The median period of amenorrhea (POA) on delivery was 38 weeks. Just over half (52.5%, n=275) underwent caesarean section. Ninety (17.2%) mothers had perineal tear(s) during labour. The prevalence of preterm births was 7.8% (n= 41). Low birth weight and macrosomia were observed among 1.5% (n=8) and 0.8% (n=4) of newborns, respectively. Fifty-four neonates (10.3%) required admission to the Neonatal Intensive Care Unit. Two babies were identified with congenital anomalies. On discharge, 39.2% and 4.6% of mothers were referred to antenatal clinics at Teaching Hospital Jaffna and the relevant medical officer of health, respectively. Conclusion: The prevalence of GDM and comorbidities highlight the need for enhanced screening and management strategies for pregnant women. The significant proportion of mothers with a family history of diabetes suggests a genetic predisposition, indicating the need for targeted education and preventative measures in high-risk populations. The incidence of neonatal and post-partum complications signal the need for vigilance in mothers with GDM during the antenatal period.