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Large-for-gestational-age newborns in women with insulin-treated gestational diabetes under strict metabolic control.
Wien Klin Wochenschr. 2005 Aug; 117(15-16):521-5.WK

Abstract

OBJECTIVE

To assess the influence of strict metabolic control in women with insulin-treated gestational diabetes on the risk of large-for-gestational-age (LGA) newborns, the frequency of obstetrical complications and fetal outcome.

METHODS

In this prospective cohort study, 875 women were screened for gestational diabetes mellitus with a 75 g oral glucose tolerance test (OGTT) between weeks 24 and 28 of gestation. The study group (n = 162) consisted of women with insulin-treated gestational diabetes mellitus (GDM) and the control group (n = 713) of women with normal glucose tolerance (NGT). In the women with diabetes, strict adjustments of fasting glucose levels to 90 mg/dl and 130 mg/dl postprandially were achieved with insulin administration.

RESULTS

No increased risk for LGA newborns was observed in women with GDM and good metabolic control (16.7% vs. 12.3%; p = 0.1). In women with NGT, maternal prepregnancy BMI was significantly higher in those who delivered LGA newborns than in those who gave birth to newborns below the 90th percentile [27.2 kg/m(2) (5.0) vs. 24.4 kg/m(2) (5.6); p = 0.006], whereas there was no influence of maternal BMI on birth weight of newborns in women with GDM. There was no difference between the two groups with respect to maternal birth traumata and fetal outcome, except for plexus palsy which occurred in three GDM women with macrosomic newborns.

CONCLUSION

Strict metabolic control and surveillance in women with insulin-treated GDM seems to attenuate the risk for LGA newborns, diabetic fetopathia, and the influence of maternal BMI on fetal growth.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

16160802

Citation

Leipold, Heinz, et al. "Large-for-gestational-age Newborns in Women With Insulin-treated Gestational Diabetes Under Strict Metabolic Control." Wiener Klinische Wochenschrift, vol. 117, no. 15-16, 2005, pp. 521-5.
Leipold H, Worda C, Gruber CJ, et al. Large-for-gestational-age newborns in women with insulin-treated gestational diabetes under strict metabolic control. Wien Klin Wochenschr. 2005;117(15-16):521-5.
Leipold, H., Worda, C., Gruber, C. J., Kautzky-Willer, A., Husslein, P. W., & Bancher-Todesca, D. (2005). Large-for-gestational-age newborns in women with insulin-treated gestational diabetes under strict metabolic control. Wiener Klinische Wochenschrift, 117(15-16), 521-5.
Leipold H, et al. Large-for-gestational-age Newborns in Women With Insulin-treated Gestational Diabetes Under Strict Metabolic Control. Wien Klin Wochenschr. 2005;117(15-16):521-5. PubMed PMID: 16160802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Large-for-gestational-age newborns in women with insulin-treated gestational diabetes under strict metabolic control. AU - Leipold,Heinz, AU - Worda,Christof, AU - Gruber,Christian J, AU - Kautzky-Willer,Alexandra, AU - Husslein,Peter W, AU - Bancher-Todesca,Dagmar, PY - 2004/09/14/received PY - 2005/04/04/accepted PY - 2005/9/15/pubmed PY - 2005/11/8/medline PY - 2005/9/15/entrez SP - 521 EP - 5 JF - Wiener klinische Wochenschrift JO - Wien Klin Wochenschr VL - 117 IS - 15-16 N2 - OBJECTIVE: To assess the influence of strict metabolic control in women with insulin-treated gestational diabetes on the risk of large-for-gestational-age (LGA) newborns, the frequency of obstetrical complications and fetal outcome. METHODS: In this prospective cohort study, 875 women were screened for gestational diabetes mellitus with a 75 g oral glucose tolerance test (OGTT) between weeks 24 and 28 of gestation. The study group (n = 162) consisted of women with insulin-treated gestational diabetes mellitus (GDM) and the control group (n = 713) of women with normal glucose tolerance (NGT). In the women with diabetes, strict adjustments of fasting glucose levels to 90 mg/dl and 130 mg/dl postprandially were achieved with insulin administration. RESULTS: No increased risk for LGA newborns was observed in women with GDM and good metabolic control (16.7% vs. 12.3%; p = 0.1). In women with NGT, maternal prepregnancy BMI was significantly higher in those who delivered LGA newborns than in those who gave birth to newborns below the 90th percentile [27.2 kg/m(2) (5.0) vs. 24.4 kg/m(2) (5.6); p = 0.006], whereas there was no influence of maternal BMI on birth weight of newborns in women with GDM. There was no difference between the two groups with respect to maternal birth traumata and fetal outcome, except for plexus palsy which occurred in three GDM women with macrosomic newborns. CONCLUSION: Strict metabolic control and surveillance in women with insulin-treated GDM seems to attenuate the risk for LGA newborns, diabetic fetopathia, and the influence of maternal BMI on fetal growth. SN - 0043-5325 UR - https://www.unboundmedicine.com/medline/citation/16160802/Large_for_gestational_age_newborns_in_women_with_insulin_treated_gestational_diabetes_under_strict_metabolic_control_ L2 - https://dx.doi.org/10.1007/s00508-005-0404-1 DB - PRIME DP - Unbound Medicine ER -