Background
Good control of maternal hyperglycaemia in gestational diabetes (GDM) is associated with improved neonatal outcomes. Amongst the logistical challenges of opening a new large public hospital, it is important to ensure that patient outcomes are maintained at a high standard.
Aims
To compare the demographics and neonatal outcomes of women and babies with GDM seen at Northern Beaches Hospital (NBH) in its first year of operation (2019) with those seen at Manly Hospital in 2015 and 2012.
Methods
A retrospective audit was conducted of all women presenting to NBH with GDM in 2019 and compared to previously available data from Manly Hospital. Data were compared with unpaired t- and X2-tests.
Results
135 women were treated for GDM at NBH in 2019 compared to 160 at Manly in 2015 and 109 in 2012. The characteristics of the women treated were not significantly different, and the proportion treated with insulin was not different. Timing and mode of delivery as well as rates of macrosomia and shoulder dystocia were not significantly different in 2019, but there was a significant increase in rate of neonatal respiratory distress (21% in 2019 vs 13% in 2015), hypoglycaemia (30% in 2019 vs 5% in 2015) and jaundice (12% in 2019 vs 3.5% in 2015). Antenatal expression of breastmilk, a new intervention introduced in 2015 which was correlated with reduced rates of neonatal hypoglycaemia, wasn’t performed at the same rate at NBH (43% in 2019 vs 85% in 2015).
Conclusion
Short-term morbidity for infants of mothers treated for GDM at NBH has increased compared to those treated at Manly Hospital. We have re-invigorated our focus on educating and assisting women with antenatal expression of breastmilk, and will closely examine how trends improve now the hospital is more well established.