Introduction: We wanted to compare the excess risk of adverse maternal and neonatal outcomes for women with diet (d-GDM) and insulin treated gestational diabetes (GDM) (i-GDM) in Sweden.
Methods: A population based cohort study including all singleton pregnancies without pre-existing diabetes recorded in the Swedish Medical Birth Register between 1998 and 2012. Logistic regression analyses were used to adjust for confounders (BMI, age, smoking, country of birth and chronic hypertension). The adjusted odds ratio (aOR) with 95% confidence interval (CI) for maternal and neonatal outcomes are presented.
Results: A total of 1,441,338 singleton pregnancies were included: 14,242 women were diagnosed with GDM (1.0%), 8,851 (62.1%) d-GDM and 5,391 (37.9%) i-GDM . Mean BMI was significantly higher than background in both groups (27.8 ± 6.0 and 30.3 ± 6.5 kg/m2 in the d-GDM group and i-GDM group, respectively, vs 24.5 ± 4.4 kg/m2, both p < 0.001). The d-GDM group had significantly higher risk for preeclampsia [aOR 1.71 (95% CI 1.55-1.88)], cesarean section [aOR 1.18 (95% CI 1.11-1.25)], LGA infants [aOR 1.85 (95% CI 1.75-1.96)] and birth injury/trauma [aOR 1.88 (95% CI 1.37-2.58)] compared to the background population. The risk was even higher in the i-GDM group, preeclampsia [aOR 2.11 (95% CI 1.88-2.36)], cesarean section [aOR 1.84 (95% CI 1.73-1.96)], LGA infants [aOR 3.38 (95% CI 3.17-3.60)] and birth injury/trauma [aOR 2.26 (95% CI 1.61-3.20)].
Conclusions: Adverse outcomes in the d-GDM group were higher than the background population and higher still among those with i-GDM.
2018.
Diabetes Pregnancy Study Group (DPSG) Meeting 2018, Rome, Italy, September 27-30, 2018