Sabzevar University of Medical Sciences, Iran
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies.
Objective: We aimed to compare the non-stress test (NST) and umbilical artery (UA) Doppler assessments for evaluation of the adverse perinatal outcomes in GDM.
Methods: We conducted a prospective cohort study on 50 pregnant women with GDM in Jame Zanan Hospital, Tehran, Iran, from Oct 2014 to Sep 2015. Adverse perinatal outcomes were defined as Apgar scores at 1-min and 5-min <7, hypoglycemia, neonatal acidosis, hypocalcemia admission to the NICU for more than 24 hours, and perinatal death.
Results: Totally, 22% and 12% of women had an abnormal UA Doppler and a non-reactive NST respectively. Poor outcomes were detected in 13 women. The most frequent poor outcomes were hypoglycemia (n=9), Apgar 1-min <7 (n=8), neonate admitted in NICU (n=6), and respiratory distress syndrome (n=6). Poor outcome was more prevalent in women with non-reactive NST (p<0.001), abnormal UA Doppler (p=0.033), and those with infant birth weight >4000 gram (p=0.033). Sensitivity and specificity of the NST in predicting different poor outcomes were 76.9% and 97.3% respectively. Sensitivity and specificity of UA Doppler in predicting different poor outcomes were 30.8% and 94.6% respectively.
Conclusion: NST is a better predictor of adverse perinatal outcomes in GDM patients.
Keywords: Diabetes, Gestational, Umbilical arteries, Ultrasonography, Prenatal diagnosis.
Mitra Eftekhariyazdi is a Perinatologist and assistant professor in Department of Obstetrics & Gynecology of Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. She did her postdoctoral research at Tehran University. She has published more than 9 research articles, and edited two books in Perinatology field. She is Deputy Head of Education.