Background
Fiona Stanley Hospital (FSH) opened to the public in 2015 and for the first time care of women with Gestational Diabetes (GDM) requiring insulin was provided to women in Perth outside of the state’s sole tertiary maternity site.
Objective
The aim of this audit was to characterize the women with GDM delivering at FSH and to determine the prevalence of early GDM and overt diabetes in pregnancy.
Methods
A retrospective audit was conducted of all women with GDM delivering at FSH (n=348) between January 2015 to January 2016. Prevalence was calculated in percentage using the total number of observed values for the particular variable being studied.
Results
Of all women delivering at FSH, 16% (n=348) had GDM with 7% (n=26) diagnosed with early GDM and 7% (n=23) with overt diabetes in pregnancy. Insulin use was common in the antenatal period (n=125, 43%). Women had significant risk factors for GDM with 28 % (n=91) of women aged ≥35 years, 49% (n=130) of women were overweight or obese, 49% (n=142) had a family history of type 2 diabetes and only 45% (n=135) were Caucasian with significant ethnic diversity in remainder of cohort. Induction of labour was performed in 41% (n=108) of women with GDM and 39% (n=135) of women with GDM required delivery by Caesarean Section. The average birth weight was 3202± 556g and no infants had a birth weight >4500gms with 6% (n=16) weighing >4000g. Most infants were exclusively breastfed on discharge (n= 193, 79%).
Conclusion
Standard GDM and associated risk factors are highly prevalent in pregnant women delivering at FSH. Insulin use in the antenatal period is common while the rate of infants with macrosomia is low. This study will assist with local and state-wide planning of diabetes in pregnancy services.