None listed
Conditions
Brief summary
Background: Current data on the rates of macrosomia in women with gestational diabetes mellitus (GDM) are heterogenous. No study has specifically examined macrosomia rates in women with diet-controlled gestational diabetes. Aims: To compare the rates of macrosomia between mothers with diet-controlled GDM to mothers without diabetes mellitus. Methods: A retrospective case-control study in which all patients with diet-controlled GDM and singleton pregnancies in a single calendar year were considered for inclusion in the study. These cases were individually matched to controls without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately). Results: 217 cases were identified with diet-controlled gestational diabetes, out of a total of 7185 births. 15 cases were excluded, leaving 202 cases in total. A total of 16 babies were >90th% and 10 were >95th% in the diet-controlled GDM group. 21 babies were >90th% and 11 were 95th% in the control group. Conclusions: Our findings suggest that macrosomia is not increased in women with diet-controlled GDM, so women with diet-controlled GDM may not require extra surveillance for fetal growth beyond that of the normal obstetric population. Provided women attend appropriate initial consultations with a diabetes educator and a dietician, are linked in with an experienced maternity centre and care-givers are familiar with blood-glucose targets, serious consideration should be given to new guidelines allowing women with diet-controlled diabetes to have obstetric care within lower risk pathways.
Interventions
A retrospective case-control study in which all patients with diet-controlled gestational diabetes mellitus (GDM) and singleton pregnancies in a single calendar year (2014) were considered for inclusion in the study. These cases were individually matched to controls without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defin
A retrospective case-control study in which all patients with diet-controlled gestational diabetes mellitus (GDM) and singleton pregnancies in a single calendar year (2014) were considered for inclusion in the study. These cases were individually matched to controls without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately). Each participant was assessed at a single time point at the birth of their child.
Sponsors
Royal Women's Hospital, Department of Maternal Fetal Medicine and Pregnancy Research Centre
Eligibility
Sex/Gender
All
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
We compared a cohort of patients with gestational diabetes managed by dietary measures with a concurrent pregnant control group matched for age, parity and body mass index. All patients with diet-controlled gestational diabetes with singleton pregnancies in a single calendar year in 2014 at the antenatal clinics of the Royal Women's Hospital, Melbourne were considered for inclusion in the study. Patients were identified using data generated from the hospital’s electronic medical record system. Control patients were selected from those without gestational, type 1 or type 2 diabetes attending for obstetric care at the same hospital. Cases and controls were matched for parity (exactly if possible, otherwise nearest available), age (within mutually exclusive five year groups partitioning the clinic patient age range, 20-24, 25-29, 30-34, 35-39, 40-44 and 45-49) and a similar partitioning of the clinic BMI range (within 5 units, 16-20, 21-25, 26-30, 31-35, 36-40, 41-45, 46-50 and 51-55). Controls were selected from the same calendar year (2014), with a date of delivery as close as possible to the date of delivery of the gestational diabetic case patient.
Exclusion criteria
Patients with multiple pregnancies were excluded, as were patients whose body mass index was unrecorded.
Outcome results
None listed