Diabetic pregnancy outcome in Malta the outcome of non-gestational diabetic pregnancies in the Maltese Islands

Diabetes in pregnancy is generally associated with a higher morbidity and mortality for both the mother and child. Objective: The study aims to assess the outcome indicators of diabetic pregnant women and compare these to the remaining obstetric population. Research Design and Methods: Women diagnosed as suffering from diabetes prior to their pregnancy were identified (n = 44) and their outcome indicators were compared to the parameters of the women with a presumed normal carbohydrate metabolism (n = 12260). Women diagnosed with gestational DM (defined as a 2-hour post-load blood glucose of >=8.6 mmol/l: n=236) were excluded from the analysis. Results: The incidence of pre-existing diabetic problems in the Maltese pregnant population is 0.35% of total maternities. Women with pre-existing DM showed themselves to be at a significantly increased risk of developing hypertensive disorders during pregnancy and to require delivery by caesarean section. The infants born to pre-existing DM women were more likely to be macrosomic or preterm and have a low Apgar score at birth. They were also more likely to be of low birth weight and suffer from respiratory distress. Conclusions: It would appear that previously existing diabetes complicating pregnancy remains a high risk situation that increases maternal and infant morbidity in spite of the modern management options.