Maternal and neonatal outcomes in a treated versus a non-treated cohort of pregnant women with GDM according to the IADPSG criteria

Maryns, Anne-Sophie; Page, Geert

doi:10.1016/j.ejogrb.2016.07.204

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…APGAR scores were not significantly different in our patients. In GDM patients who were untreated, Maryns et al 24 found that there were more cases of pre-eclampsia and more neonatal admissions than in the treated group. In addition, pregnancy duration was shorter and APGAR score at five minutes was significantly lower in the untreated than the treated group.…”

Section: Discussionmentioning

confidence: 99%

Early Pregnancy Glycemic Levels in Non-Diabetic Women and Pregnancy Outcome: A Retrospective Cross-Sectional Study

Al-Husban

Abu-Hassan

Qatawneh

et al. 2021

IJGM

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Background: Maternal fasting blood sugar (FBS) variations within normal range and lower than that in diabetes mellitus (DM) may be associated with adverse feto-maternal outcomes. Objective: To find out if a rise of maternal FBS level above 80 but still below 120 mg/dL (group 2) has an influence on feto-maternal outcomes compared with a maternal FBS below 80 mg/dL (group 1). Methods: Retrospective cross-sectional study. FBS was measured at the booking visit. Subjects whose FBS was measured before 20 weeks were categorized according to their FBS (>80 mg/dL or ≤80 mg/dL) and correlation between FBS levels in the two groups with several parameters were tested. Results: Group 1 (130 healthy pregnant women) and group 2 (88 healthy pregnant women) did not show a statistical difference in age or BMI. More statistically significant cases were diagnosed with GDM in group 2 than in group 1 (39.8% vs 16.9%, P value 0.000). More cases that needed pharmacological intervention in the form of metformin or insulin or both were seen in group 2 than in group 1 (p value 0.007 and 0.061, respectively). More but not statistically significant polyhydramnios was seen more in group 2 than in group 1 (9.1% vs 3.1%, p value 0.056). There was no statistically significant difference between the 2 groups in relation to all other fetomaternal outcome parameters that were studied. Conclusion: Raised maternal fasting blood glucose level (80-120 mg/dL) in healthy primigravid women in early pregnancy was associated with significant diagnosis of gestational diabetes mellitus and need for pharmacological intervention. An association was found with polyhydramnios but this was not statistically significant. No influence was found on preterm birth, fetal weight, mode of delivery or APGAR score. More attention should be given to FBS levels early in pregnancy to reduce the risk for later complications.

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Section: Discussionmentioning

confidence: 99%

Early Pregnancy Glycemic Levels in Non-Diabetic Women and Pregnancy Outcome: A Retrospective Cross-Sectional Study

Al-Husban

Abu-Hassan

Qatawneh

et al. 2021

IJGM

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“…However, those studies were retrospective, and the comparison groups were women with normal glucose tolerance or GDM determined through different glucose cut-off values or diagnostic methods, such as 100 g OGTT [8][9][10]. A recent study reported that no differences were noted between untreated and treated patients diagnosed by the IADPSG criteria [11]. Furthermore, evidence of improvements in perinatal outcomes of the treatment of milder GDM by the IADPSG criteria is still limited.…”

Section: Treatment Of Gestational Diabetes Diagnosed By the Iadpsg Crmentioning

confidence: 99%

Treatment of gestational diabetes diagnosed by the IADPSG criteria decreases excessive fetal growth

et al. 2020

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Objective We evaluated the effect on treatment using the new International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) diagnosis. Methods Singleton pregnant women whose plasma glucose levels were ≥140 mg/dL on the 50 g glucose challenge test (GCT) underwent 75 g oral glucose tolerance for GDM diagnosis. During the first half of the study period, GDM was diagnosed using 2 abnormal values by Carpenter-Coustan (C-C) criteria. In the second half of the study period, 1 or more abnormal values by IADPSG criteria were used for GDM diagnosis. Pregnant women were classified into 5 groups: normal 50 g GCT, positive 50 g GCT but non-GDM, GDM by IADPSG criteria and non-treated, GDM by IADPSG criteria and treated, GDM by CC criteria and treated. The odds ratios (ORs) for large for gestational age (LGA) and macrosomia were analyzed. Results Of the 2,678 patients, the frequency of GDM diagnosed by CC and IADPSG criteria was 2.6% and 7.5%. ORs (95% confidence intervals [CIs]) for LGA and macrosomia in the group with GDM by IADPSG criteria and non-treated were 2.81 (95% CI, 1.47-5.38) and 2.84 (95% CI, 1.08-7.47). The risk of LGA and macrosomia did not increase in the group with GDM by IADPSG criteria and treated. Conclusion The risk of LGA and macrosomia for mild GDM diagnosed solely by IADPSG criteria depends on whether they are treated or not. Treatment of GDM based on IADPSG criteria reduces the risk of excessive fetal growth.

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“…A study of hyperglycemia and adverse pregnancy outcomes showed that pregnant women with untreated blood glucose control developed preeclampsia compared with pregnant women with treated blood glucose control. Moreover, the proportion of newborns admitted to the intensive care unit increased and the Apgar 5-minute score of newborns decreased significantly ( 10 ). Therefore, to better control blood glucose levels, indicators reflecting blood glucose control should be adopted.…”

Section: Introductionmentioning

confidence: 99%

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

Yu¹,

Liu²,

Wu³

2023

Ann Transl Med

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Background Blood glucose variability (GV) is believed to be closely related to the occurrence of adverse obstetric outcomes. However, few studies have investigated how the change in fasting plasma glucose (FPG) influenced on the adverse obstetric outcomes. This study mainly evaluated the relationship between FPG coefficient of variation (FPG-CV) and adverse outcomes in patients with gestational hyperglycemia and determine the ideal FPG-CV threshold for predicting maternal and infant outcomes. Methods We retrospective analyzed the data of 608 pregnant hyperglycemic patients in the Obstetrics Department of Shengjing Hospital Affiliated to China Medical University between June 2019 and December 2021 and followed up inpatients through the Hospital Information System (HIS). We collected the venous FPG from 24–28 weeks of pregnancy to delivery. Maternal and infant outcomes were based on the latest definitions. The chi-square test and logistic regression analysis were performed to evaluate the correlation between FPG-CV and adverse outcomes. Two multivariate binary logistic regression models were used to adjust for confounding factors. Stratified analysis was performed according to hemoglobin A1c (HbA1c) levels (<5.9% and ≥5.9%) and insulin injection (not used and used) in the third trimester of pregnancy. The receiver operating characteristic (ROC) curve was used to evaluate the prediction of FPG-CV on adverse outcomes. Results All patients were divided into four groups based on the quartile of FPG-CV. The proportion of FPG-SD and insulin injections differed among the groups (P<0.05). Among the outcomes, the highest incidence rate was 26.3% for large for gestational age (LGA), 8.7% for premature delivery. FPG-CV remains independently associated with low birth weight [odds ratio (OR) =1.086, P=0.007], preterm birth (OR =1.069, P=0.012), and preeclampsia (OR =1.180, P<0.001). FPG-CV can predict preeclampsia, with an area under the curve (AUC) of 0.725. Conclusions Our results suggest that patients with gestational hyperglycemia should undergo routine FPG monitoring from diagnosis to delivery. Also, the impact of blood glucose fluctuations on adverse outcomes should be considered in the clinical treatment. The rational application of hypoglycemic treatment can stabilize blood glucose levels, however, the effects of different regimens on GV and outcomes should be studied further.

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Maternal and neonatal outcomes in a treated versus a non-treated cohort of pregnant women with GDM according to the IADPSG criteria

Cited by 4 publications

References 11 publications

Early Pregnancy Glycemic Levels in Non-Diabetic Women and Pregnancy Outcome: A Retrospective Cross-Sectional Study

Early Pregnancy Glycemic Levels in Non-Diabetic Women and Pregnancy Outcome: A Retrospective Cross-Sectional Study

Treatment of gestational diabetes diagnosed by the IADPSG criteria decreases excessive fetal growth

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

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