Maternal and Fetal Outcomes if Gestational Impaired Glucose Tolerance Is Not Treated
Maternal and Fetal Outcomes if Gestational Impaired Glucose Tolerance Is Not Treated Ingrid Östlund , MD, PHD 1 2 , Ulf Hanson , MD, PHD 1 , Anders Björklund , MD, PHD 3 , Ragnhild Hjertberg , MD, PHD 4 , Nord Eva , MD 5 , Elisabeth Nordlander , MD, PHD 5 , Swahn Marja-Liisa , MD, PHD 6 and Jan Wage...
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Published in | Diabetes care Vol. 26; no. 7; pp. 2107 - 2111 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Alexandria, VA
American Diabetes Association
01.07.2003
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Subjects | |
Online Access | Get full text |
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Summary: | Maternal and Fetal Outcomes if Gestational Impaired Glucose Tolerance Is Not Treated
Ingrid Östlund , MD, PHD 1 2 ,
Ulf Hanson , MD, PHD 1 ,
Anders Björklund , MD, PHD 3 ,
Ragnhild Hjertberg , MD, PHD 4 ,
Nord Eva , MD 5 ,
Elisabeth Nordlander , MD, PHD 5 ,
Swahn Marja-Liisa , MD, PHD 6 and
Jan Wager , MD, PHD 6
1 Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
2 Department of Obstetrics & Gynecology, Örebro University Hospital, Örebro, Sweden
3 Danderyd’s Hospital, Stockholm, Sweden
4 Stockholm South Hospital and Octavia Clinic, Stockholm, Sweden
5 Karolinska Hospital, Stockholm, Sweden
6 Huddinge University Hospital, Stockholm, Sweden
Address correspondence and reprint requests to Ingrid Östlund, MD, Department of Obstetrics & Gynecology, Örebro University
Hospital, SE-701 85 ÖREBRO, Sweden. E-mail: ingrid.ostlund{at}orebroll.se .
Abstract
OBJECTIVE —To evaluate whether there is increased maternal or neonatal morbidity in connection with impaired glucose tolerance (IGT)
during pregnancy when the condition is not treated.
RESEARCH DESIGN AND METHODS —During the study period of 1997–2001, in a defined geographical area in Sweden, the diagnostic criteria for gestational diabetes
mellitus (GDM) were limited to the criteria for diabetes. Prospectively, 213 women who were identified with IGT during pregnancy
were undiagnosed and untreated. Data on maternal and fetal outcome was collected from records. For each case subject, four
control subjects were taken from the same delivery department.
RESULTS —The proportion of women who underwent cesarean section was significantly higher in the case subjects than in the control
subjects and was independently associated with IGT. The adjusted odds ratio (OR) was 1.9 (95% CI 1.2–2.9). The proportion
of infants who were large for gestational age (LGA), defined as birth weight >2 SDs greater than the mean for gestation and
sex, was independently significantly associated with untreated IGT during pregnancy (OR 7.3, 95% CI 4.1–12.7). Admission to
a neonatal intensive care unit (NICU) for 2 days or longer was more common (adjusted OR 2.0, 95% CI 1.1–3.8). However, 71.3%
of the children in the IGT group and 87.3% of the control subjects had no neonatal complications.
CONCLUSIONS —There is increased independent association between cesarean section rate, prematurity, LGA, and macrosomic infants born to
mothers with untreated IGT. Most of the children were healthy, but there is still increased morbidity. Therefore, to evaluate
the effects of treatment, there is a need for a randomized study.
GDM, gestational diabetes mellitus
IGT, impaired glucose tolerance
LGA, large for gestational age
NICU, neonatal intensive care unit
OGTT, oral glucose tolerance test
PIH, pregnancy-induced hypertension
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted March 23, 2003.
Received November 11, 2002.
DIABETES CARE |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0149-5992 1935-5548 1935-5548 |
DOI: | 10.2337/diacare.26.7.2107 |