Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus.
BACKGROUND
This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group.


METHODS
A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM.


RESULTS
GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively.


CONCLUSIONS
Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.
Berg
Marie
M
The Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, and Department of Obstetrics and Gynaecology, The Institute of Clinical Sciences, Sahlgrenska University Hospital, Sweden. marie.berg@fhs.gu.se
Adlerberth
Annika
A
Sultan
Bo
B
Wennergren
Margareta
M
Wallin
Gunnar
G
D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008403:Mass Screening; D009765:Obesity / Q000453:epidemiology; D010298:Parity; D010348:Patient Care Team; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012720:Severity of Illness Index; D050497:Stillbirth; D013548:Sweden / Q000453:epidemiology
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin