Objective- To compare the pregnancy complications and fetal outcomes in pregnancies complicated by diabetes mellitus. Design- A retrospective cohort study. Setting- Abha Maternity Hospital, Abha, Saudi Arabia. Materials and methods- One hundred and eighty five diabetic pregnant patients who delivered at the Abha Maternity Hospital during the 3-year-period from April 2000-March 2003 formed the subjects of this study. There were 27(14.6%) (type 1) - insulin dependent diabetics, group 1, 19 (10.2%)(type 2), non insulin dependent diabetic patients who constituted group 2 and 139(75.2%) gestational diabetic patients who made up group 3. Data extracted from the case files included maternal age, gravidity, parity, number of abortions, gestational age at booking, time of diagnosis of diabetes mellitus, complications during pregnancy, birth weight, placental weight. Results- There were no statistically significant differences in the three groups regarding the mean gravidity, parity, birth weight and placental weight (p>0.05). However, statistically significant differences were found with respect to the mean maternal age, gestation at booking, fasting blood sugar, and gestation at delivery (p<0.05). Out of 139 gestational diabetics, 23(16.5%) were diagnosed by the 14th week of pregnancy while 24(17.2%) were diagnosed between the 15-27 weeks of gestation. The control of blood sugar was adjudged to be poor in 32% of gestational diabetics, 50% of type 2 diabetics and 69% of type 1 diabetics, with statistically significant difference between the groups, (p<0.05). Although there was statistically significant difference between the groups regarding one of the pregnancy complications (polyhydramnios) (p<0.05), none were found in other complications (p>0.05). The overall caesarean section rate was48%. The overall perinatal mortality was 5.7%, all the deaths occurred in babies born to patients with gestational diabetes. Conclusion- Gestational diabetes accounted for all the fetal losses in this study, while polyhydramnios was the most common antenatal complication which was significantly higher in type 1 diabetics.
