In a nutshell
This study examined whether treating mild gestational diabetes is associated with improved pregnancy outcomes.
Some background
Gestational diabetes is glucose (sugar) intolerance that occurs during pregnancy. This leads to hyperglycemia (high blood glucose levels). Mild gestational diabetes is defined as women who have only one abnormal oral glucose tolerance test (OGGT – a test that measures the body's ability to use sugar). Maternal hyperglycemia results in the fetus producing more insulin. This leads to the fetus potentially having low blood glucose levels and low blood calcium levels. Fetal complications such as stillbirth and a large-for-gestational-age (LGA) infant can occur as a result of gestational diabetes.
Methods & findings
This study aimed to determine whether pregnancy outcomes are improved when patients with gestational diabetes receive treatment. This study involved 893 women from 30 hospitals. There were three groups of patients. One group did not receive treatment for diabetes (542 women). One group made dietary changes (172 women). One group made dietary changes and received insulin therapy (178) women.
Pregnancy outcomes included neonatal complications (problems with the newborn) and maternal outcomes. Perinatal mortality (stillbirth and neonatal death) was recorded. Congenital malformations, LGA, birth weight greater than 4000 g, hyperglycemia and respiratory distress syndrome (where babies have difficulty breathing due to underformed lungs) were also recorded. Maternal weight gain, gestational hypertension, pre-eclampsia (high blood pressure with organ damage) and caesarean section were noted.
Pre-pregnancy body mass index (BMI – measurement based on height and weight) and gestational weight gain were associated with a higher risk of having an LGA infant. In women receiving treatment, the frequency of LGA infants was lower. There was no difference between treatment and non-treatment for other neonatal complications. Gestational weight gain was also lower in women receiving treatment.
The bottom line
This study concluded that maternal BMI has an impact on fetal growth. Treating overweight or obese women is associated with a lower frequency of LGA infants.
The fine print
Women with more than one abnormal OGGT value may have been included. Therefore, not all women may have had mild gestational diabetes.
What’s next?
Consult your physician regarding the risks and benefits of treating gestational diabetes.
Published By :
Diabetes Research and Clinical Practice
Date :
Jan 15, 2014
