Glucose screening during active labour for the detection of undiagnosed hyperglycaemia and newborn malformations in a population without prenatal care.
OBJECTIVE
This prospective study was undertaken to look at the frequency of hyperglycaemia in pregnant women who were without health benefits and did not receive prenatal specialist care, and to examine the relationship between fetal complications and the prenatal care received.


METHODS
The subjects consisted of 304 pregnant women, divided into two groups. Group I included 176 women who had inadequate prenatal care (73 women with irregular care, and 103 women without any specialist care.) with a mean of 1.1 visits to a specialist. Group II included 128 women who had regular prenatal care with a mean of 6.5 consultations per patient.


RESULTS
There were no statistical differences between the two groups in relation to maternal age, obstetrical history and gestational weeks. The familial antecedent of diabetes was found in 30.1% of women in group I and 19.5% of women in group II (p < 0.05). Hyperglycaemia was found in 55 (31.2%) patients in group I and 4 (3.1%) patients in group II (p < 0.001) with mean blood glucose levels of 163 and 130 mg/dL respectively. Clinical characteristics of newborns show statistically significant increased abnormalities in 15.9% of babies whose mothers had inadequate prenatal care vs. 3.9% of babies whose mothers had regular prenatal care. The abnormalities seen were myelomeningocele, cleft lip and palate, oesophageal atresia, polydactyly, phocomelia and encephalocele.


CONCLUSIONS
The frequency of hyperglycaemia in pregnant women with inadequate prenatal care was higher than in pregnant women with regular prenatal care. Additionally newborn abnormalities and complications occurred more frequently in babies of mothers with inadequate prenatal care. The benefits of prenatal care are evident and it is important to improve and start instituting new programmes and ways of making health information available to women in primary care clinics to educate the general population and stress the importance of regular visits to a prenatal care specialist.
Hernandez-Valencia
M
M
Department of Obstetrics and Gynecology, General Hospital Dr Jose Ma. Rodriguez ISEM-SSA, Mexico City, Mexico. mhernandezvalencia@prodigy.net
Carrillo Pacheco
A
A
D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D008403:Mass Screening; D008423:Maternal Age; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*