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Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to2003
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-2691-7525
Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden.
Statistical and Epidemiology Unit, Örebro University Hospital, Örebro, Sweden.
Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
2010 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 27, no 4, p. 436-441Article in journal (Refereed) Published
Abstract [en]

Aims To determine maternal and neonatal outcomes for women with gestational diabetes mellitus (GDM) in Sweden during 1991–2003, and to compare the outcomes in the two time periods.

Methods This is a population-based cohort study using the Swedish Medical Birth Register data for the period 1991–2003. There were 1 260 297 women with singleton pregnancies registered during this time, of whom 10 525 were diagnosed with GDM, based on a 75 g oral glucose tolerance test. The main diagnostic criteria were fasting capillary whole blood glucose ≥ 6.1 mmol⁄l and 2 h blood glucose ≥ 9.0 mmol⁄l.

Results Maternal characteristics differed significantly between the GDM and non-GDM group. Adjusted odds ratios (OR) were as follows: for pre-eclampsia, 1.81 (95% confidence interval (CI) 1.64–2.00); for shoulder dystocia, 2.74 (2.04–3.68); and for Caesarean section, 1.46 (1.38–1.54).No difference was seen in perinatal mortality, stillbirth rates, Apgar scores, fetal distress or transient tachypnoea. There was a markedly higher risk of large for gestational age,OR3.43 (3.21–3.67), and Erb’s palsy, OR 2.56 (1.96–3.32), in the GDMgroup, and statistically significant differences in prematurity < 37 weeks, birthweight > 4.5 kg, and major malformation, OR 1.19–1.71. No statistically significant improvement in outcomes was seen between the two study periods.

Conclusions Women with GDM have higher risks of pre-eclampsia, shoulder dystocia and Caesarean section. Their infants are often large for gestational age and have higher risks of prematurity, Erb’s palsy and major malformations. These outcomes did not improve over time.

Place, publisher, year, edition, pages
Malden 02148, MA USA: Wiley-Blackwell, 2010. Vol. 27, no 4, p. 436-441
Keywords [en]
gestational diabetes mellitus, maternal outcome, neonatal outcome
National Category
Medical and Health Sciences Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-21259DOI: 10.1111/j.1464-5491.2010.02978.xISI: 000276466600011OAI: oai:DiVA.org:oru-21259DiVA, id: diva2:482023
Available from: 2012-01-23 Created: 2012-01-23 Last updated: 2019-04-24Bibliographically approved
In thesis
1. Gestational diabetes mellitus in Sweden: screening, outcomes, and consequences
Open this publication in new window or tab >>Gestational diabetes mellitus in Sweden: screening, outcomes, and consequences
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 68
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 65
Keywords
Gestational diabetes mellitus, fasting blood glucose, screening, neonatal and obstetric outcomes, ethnicity, cardiovascular disease
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-20621 (URN)978-91-7668-847-2 (ISBN)
Public defence
2012-02-17, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2011-12-22 Created: 2011-12-22 Last updated: 2019-04-24Bibliographically approved

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Fadl, Helena E.

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