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Outcomes of pregnancies affected by impaired glucose tolerance.
Diabetes Res Clin Pract 2007; 77(2):263-8DR

Abstract

OBJECTIVE

Gestational diabetes mellitus (GDM) is associated with an increase in both maternal and neonatal morbidity. There remains uncertainty, however, about the diagnostic criteria for GDM. We compared pregnancy outcomes across three groups of women, with the aim of establishing a threshold for diagnosis of GDM at our institution.

METHODS

Women with a glucose tolerance test (GTT) were identified on the hospital's pathology database. Those women with a singleton pregnancy, in whom a GTT had demonstrated a fasting value </=5.5mmol/L, 2-h blood sugar >/=7.8mmol/L and who confined </=34 weeks gestation were eligible for inclusion. Outcomes were collected from the medical records and obstetric database. These women were managed with either diet modification, regular endocrinologist review and standard antenatal care if the GTT met ADA criteria (n=265, TREATED), or standard antenatal care alone if the GTT did not fulfil ADA criteria (n=213, UNTREATED). A third group comprised of women with normal GTT who received identical treatment to the untreated group (n=197, COMPARISON). Statistical analysis was conducted with chi(2) and ANOVA.

RESULTS

In women with untreated GDM, there was significantly more macrosomia, shoulder dystocia, and preeclampsia, compared with the comparison group. These rates were similar between the treated and comparison groups. There were no significant differences in induction of labour, caesarean section rates, or gestational age at delivery between the groups.

CONCLUSION

Untreated GDM is associated with larger babies and more birth trauma. We recommend the diagnosis of GDM be made with fasting glucose >/=5.5mmol/L and/or 2h >/=7.8mmol/L on 75g GTT.

Authors+Show Affiliations

Perinatal Research Group, Kolling Institute, University of Sydney, Royal North Shore Hospital, Pacific Highway, St. Leonards, NSW 2065, Sydney, Australia. mkwik8@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17275121

Citation

Kwik, M, et al. "Outcomes of Pregnancies Affected By Impaired Glucose Tolerance." Diabetes Research and Clinical Practice, vol. 77, no. 2, 2007, pp. 263-8.
Kwik M, Seeho SK, Smith C, et al. Outcomes of pregnancies affected by impaired glucose tolerance. Diabetes Res Clin Pract. 2007;77(2):263-8.
Kwik, M., Seeho, S. K., Smith, C., McElduff, A., & Morris, J. M. (2007). Outcomes of pregnancies affected by impaired glucose tolerance. Diabetes Research and Clinical Practice, 77(2), pp. 263-8.
Kwik M, et al. Outcomes of Pregnancies Affected By Impaired Glucose Tolerance. Diabetes Res Clin Pract. 2007;77(2):263-8. PubMed PMID: 17275121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of pregnancies affected by impaired glucose tolerance. AU - Kwik,M, AU - Seeho,S K M, AU - Smith,C, AU - McElduff,A, AU - Morris,J M, Y1 - 2007/02/01/ PY - 2006/10/02/received PY - 2006/12/09/accepted PY - 2007/2/6/pubmed PY - 2007/8/8/medline PY - 2007/2/6/entrez SP - 263 EP - 8 JF - Diabetes research and clinical practice JO - Diabetes Res. Clin. Pract. VL - 77 IS - 2 N2 - OBJECTIVE: Gestational diabetes mellitus (GDM) is associated with an increase in both maternal and neonatal morbidity. There remains uncertainty, however, about the diagnostic criteria for GDM. We compared pregnancy outcomes across three groups of women, with the aim of establishing a threshold for diagnosis of GDM at our institution. METHODS: Women with a glucose tolerance test (GTT) were identified on the hospital's pathology database. Those women with a singleton pregnancy, in whom a GTT had demonstrated a fasting value </=5.5mmol/L, 2-h blood sugar >/=7.8mmol/L and who confined </=34 weeks gestation were eligible for inclusion. Outcomes were collected from the medical records and obstetric database. These women were managed with either diet modification, regular endocrinologist review and standard antenatal care if the GTT met ADA criteria (n=265, TREATED), or standard antenatal care alone if the GTT did not fulfil ADA criteria (n=213, UNTREATED). A third group comprised of women with normal GTT who received identical treatment to the untreated group (n=197, COMPARISON). Statistical analysis was conducted with chi(2) and ANOVA. RESULTS: In women with untreated GDM, there was significantly more macrosomia, shoulder dystocia, and preeclampsia, compared with the comparison group. These rates were similar between the treated and comparison groups. There were no significant differences in induction of labour, caesarean section rates, or gestational age at delivery between the groups. CONCLUSION: Untreated GDM is associated with larger babies and more birth trauma. We recommend the diagnosis of GDM be made with fasting glucose >/=5.5mmol/L and/or 2h >/=7.8mmol/L on 75g GTT. SN - 0168-8227 UR - https://www.unboundmedicine.com/medline/citation/17275121/Outcomes_of_pregnancies_affected_by_impaired_glucose_tolerance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(06)00560-2 DB - PRIME DP - Unbound Medicine ER -