(750) Gestational Diabetes Mellitus in Pregnancies with Suspected Growth Restriction: Blessing or Curse?

Objective: Fetal growth restriction (FGR) is a condition that occurs when a fetus fails to achieve its growth potential. Gestational diabetes mellitus (GDM) is another common complication during pregnancy associated with accelerated fetal growth. This study aims to evaluate the impact of GDM on perinatal outcomes in pregnancies with suspected fetal growth impermanent.

Study Design: This retrospective cohort study enrolled singleton pregnancies without fetal genetic or structural abnormalities and EFW and/or AC below the 10^th centile for gestational age on the last sonographic assessment within 14 days from delivery. The study compared pregnancies with GDM to those without GDM. The primary outcome of interest was the o ccurrence of composite adverse perinatal outcomes. Multivariable logistic regressions were performed, adjusting for relevant covariates.

Results: A total of 1,583 patients were included in the study, with 234 (14.8%) diagnosed with GDM, while 1,349 (85.2%) did not . Patients with GDM were found to be older, had a higher body weight, and had higher rates of hypertensive disorders compared to those without GDM. Patients with GDM experienced longer pregnancies, with a difference of approximately one week, but there were no significant differences in the rates o f preterm labor (< 37 weeks). The rates of labor induction and mode of delivery were comparable between the GDM and non-GDM groups. Neonates born to mothers with GDM had higher birthweight and lower adverse perinatal outcome rates than neonates of normoglycemic pregnancies (45.2% vs. 52.2%; p=0.04). In the multivariate analysis, which controlled for maternal age, parity, oligohydramnios, hypertensive disorders of pregnancy, gestational age at delivery, and birthweight, it was found that GDM was significantly and independently associated with lower adverse perinatal outcome (adjusted odds ratio=0.65, 95% confidence interval 0.47-0.9) (Table).

Conclusion: GDM significantly impacts perinatal outcomes in pregnancies with suspected fetal growth impairment and can potentially improve the overall outcome in such cases.