Gestational diabetes mellitus in women in the fourth decade--is treatment worthwhile?
OBJECTIVE
To examine the influence of diet-treated gestational diabetes mellitus on the obstetric performance of mothers aged 40 and above.


METHODS
We reviewed the delivery records of 205 mothers aged 40 and above who delivered over a 3-year period. A 75-gram oral glucose tolerance test was performed in all cases and 64 (31.2%) (18 primiparas and 46 multiparas) had gestational diabetes mellitus. This affected group of patients was compared with a group of age- and parity-matched controls to determine the impact of gestational diabetes mellitus on the obstetric outcome.


RESULTS
There was no difference in the maternal anthropometric parameters, antenatal complications, or labor performance. While no statistically significant difference was found in the infant anthropometric parameters, the study group had a lower incidence (p = 0.043) of large-for-gestational age infants.


CONCLUSIONS
Our findings suggested the adverse effects of gestational diabetes mellitus on pregnancy outcome were confounded to a large extent by other factors such as age, parity, and obesity. Once compared with matched controls, gestational diabetes mellitus that can be successfully treated with diet therapy probably had minimal adverse effect on the obstetric outcome. Furthermore, diet treatment can probably reverse the effect of advanced maternal age on infant size in these women.
Chan
Ben Chong Pun
BC
Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. bcpchan@hkucc.hku.hk
Lao
Terence Tzu Hsi
TT
D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000178:diet therapy*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies