Audit of maternal and fetal outcomes in women treated for glucose intolerance during pregnancy.
OBJECTIVE
To determine whether one should aim for glycaemia that is statistically 'normal' or for levels of glycaemia low enough to prevent macrosomia (if such a threshold exists) when glucose intolerance is detected during pregnancy.


METHODS
An audit of pregnancy outcomes in women with impaired glucose tolerance in pregnancy as compared to a local age-matched reference group with normal glucose tolerance.


RESULTS
Our study suggests that for most patients, more intensive therapy would not have been justified. Maternal smoking appeared to convey some 'advantages' in terms of neonatal outcomes, with reduction in large-for-gestational-age (LGA) infants and jaundice in babies of impaired glucose tolerance (IGT) mothers.


CONCLUSIONS
These observations demonstrate the importance of considering risk factors other than GTT results in analysing pregnancy outcomes, while emphasising that 'normalisation' of fetal size should not be our only therapeutic endpoint. Our detailed outcome review allows us to reassure patients with GDM that with current treatment protocols, they should have every expectation of a positive pregnancy outcome.
McIntyre
H David
HD
Mater Misericordiae Mothers' Hospital, South Brisbane, Queensland, Australia.
Begg
Lisa M
LM
Parry
Annette F
AF
Oats
Jeremy
J
D000704:Analysis of Variance; D001724:Birth Weight; D016022:Case-Control Studies; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis; D016014:Linear Models; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011296:Prenatal Diagnosis; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D007004:Hypoglycemic Agents