title: The impact of glycemic control on neonatal outcome in singleton pregnancies complicated by gestational diabetes.
abstract: OBJECTIVE
  To identify the impact of suboptimal blood glucose control on neonatal outcomes in women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  Included were patients with singleton gestation enrolled in an outpatient GDM management program for at least 7 days who delivered at term. Blood glucose control was defined as an average fasting blood glucose of <95 mg/dl, 1-h postprandial of <140 mg/dl, or 2-h postprandial of <120 mg/dl. Data were compared between patients with optimal blood glucose control (n = 2,030) and those with suboptimal blood glucose control (n = 1,188). The primary study outcome was a composite variable consisting of macrosomia, large-for-gestational-age, hypoglycemia, jaundice, or stillbirth.
  
  
  RESULTS
  Over one-third of infants in the poorly controlled group were positive for at least one factor comprising the composite variable compared with 24% from the controlled group (P < 0.001).
  
  
  CONCLUSIONS
  Suboptimal glycemic control in women with GDM is associated with adverse neonatal outcome. Careful monitoring of blood glucose levels and initiation of appropriate treatment are essential in the care of women with GDM.
authors.affiliation: Department of Obstetrics and Gynecology, University of Miami, P.O. Box 016960 (R-136), Miami, FL 33101, USA. vhgonzalez@med.miami.edu
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: González-Quintero
authors.forename: Niki B
authors.initials: NB
authors.lastname: Istwan
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Rhea
authors.forename: Lorna I
authors.initials: LI
authors.lastname: Rodriguez
authors.forename: Amanda
authors.initials: A
authors.lastname: Cotter
authors.forename: Jena
authors.initials: J
authors.lastname: Carter
authors.forename: Antoaneta
authors.initials: A
authors.lastname: Mueller
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Stanziano
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D009765:Obesity / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin