Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile.
OBJECTIVE
To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes.


METHODS
The records of 143 consecutive GDM pregnancies and 143 non-diabetic controls matched on the basis of age, parity and pre-pregnancy body mass index (BMI) were studied. The GDM patients were treated with diet, tolbutamide and insulin. Data were collected from medical records and birth records.


RESULTS
Despite treatment, the GDM group had a statistically significant higher frequency of maternal hypertension (20% vs. 11%), induction of labour (61% vs. 24%), Caesarean section (33% vs. 21%), macrosomia (14% vs. 6%), neonatal hypoglycaemia (24% vs. 0) and admission to a neonatal unit (46% vs. 12%). The risk of complications was similar in the different treatment groups. However, in the tolbutamide-treated group, one case of long-standing severe hypoglycaemia in a premature neonate occurred.


CONCLUSIONS
Pregnancies complicated by GDM are associated with a higher frequency of adverse maternal and fetal outcomes. The outcomes seem to be unaffected by treatment modality. However, because of the potential risk of hypoglycaemia in some neonates, tolbutamide treatment cannot be recommended in pregnancy.
Jensen
D M
DM
Department of Endocrinology, Odense University Hospital, Denmark. dm.jensen@winsloew.ou.dk
Sørensen
B
B
Feilberg-Jørgensen
N
N
Westergaard
J G
JG
Beck-Nielsen
H
H
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D003718:Denmark; D016640:Diabetes, Gestational; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007751:Labor, Induced / Q000706:statistics & numerical data; D008423:Maternal Age; D008499:Medical Records; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose