Introduction: Gestational Diabetes Mellitus (GDM) patients are stratified into “low-risk” and “high-risk” groups in Canberra, according to whether they can control their glucose level with diet and exercise. High-risk patients, mostly needing insulin treatment, are referred to the multidisciplinary clinic, while low-risk patients continue normal antenatal care. The aim was to determine if low-risk patients have satisfactory outcomes considering their lower level of obstetric surveillance.
Methods: A retrospective clinical audit of GDM patients treated between 2010 and 2012 was conducted. Maternal demographic data and neonatal and maternal clinical outcomes data were analysed.
Results: Records of 337 patients were reviewed. Low-risk compared to high-risk mothers were younger (31.69±4.91 vs. 33.01±4.97 years, P<0.05), leaner (BMI 26.4±6.73 vs. 30.7±8.24 kg/m2, p<0.0001), with lower rates of pre-eclampsia (2.2% vs. 8.0%), induced labor (15.2% vs. 50.9%) and elective C-sections (12.5% vs. 20.5%); but had more premature deliveries (13.8% vs. 8.0%), low-birth-weight neonates (9.4% vs. 6.2%, n.s.), macrosomic neonates (7.1% vs. 5.4%, n.s.). Emergency C-section rates were similar (14.7% vs. 13.4%).
Conclusion: The stratification system into low and high-risk GDM is efficient. The low-risk group, however, is at increased risk of premature delivery and a similarly high rate of emergency C-section as the high-risk group.