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Maternal and fetal outcomes if gestational impaired glucose tolerance is not treated
Örebro University, Department of Clinical Medicine.
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2003 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 26, no 7, p. 2107-2111Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2003. Vol. 26, no 7, p. 2107-2111
Keywords [en]
Adult, Birth Weight, Body Weight, Cesarean Section/statistics & numerical data, Diabetes; Gestational/*complications, Female, Glucose Intolerance/*diagnosis, Humans, Hypertension/epidemiology, Infant; Newborn, Infant; Premature, Intensive Care Units; Neonatal/statistics & numerical data, Odds Ratio, Pregnancy, Pregnancy Complications/diagnosis, Pregnancy Outcome, Reference Values, Sweden
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-4666DOI: 10.2337/diacare.26.7.2107PubMedID: 12832321OAI: oai:DiVA.org:oru-4666DiVA, id: diva2:138965
Note

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.

Available from: 2008-10-27 Created: 2008-10-27 Last updated: 2017-12-14Bibliographically approved

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Östlund, Ingrid

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