A retrospective multi-institutional study of treatment for mild gestational diabetes in Japan.
OBJECTIVE
To determine whether treating mild gestational diabetes mellitus (GDM) is associated with improvement of pregnancy outcomes in Japan.


METHODS
In a multi-institutional retrospective study, we examined pregnant women meeting the criteria for mild GDM (i.e., only one abnormal value [OAV] for 75-g OGTT; fasting glucose ≥100 mg/dL, 1-h postprandial glucose ≥180 mg/dL, and 2-h postprandial glucose ≥150 mg/dL), receiving either routine prenatal care (non-treatment group) or dietary intervention alone or dietary intervention with self-monitoring of blood glucose and/or insulin therapy, if necessary (treatment group). Pregnancy outcomes were compared between these groups.


RESULTS
Data from 893 eligible women were collected from 30 institutions. Participants included 542 untreated and 351 treated women. Although there were no significant differences in baseline clinical characteristics or maternal and perinatal outcomes between these groups, the incidence of large-for-gestational-age (LGA) infants was lower in the treatment group (P=0.07). Multiple logistic regression analysis (MLRA) revealed that pre-pregnancy BMI and gestational weight gain were associated with LGA infants, while 75-g OGTT results were unrelated to LGA. When overweight and obese women were the subjects, the number of LGA infants was significantly lower in the intervention than in the control group, and gestational weight gain was significantly lower in the treatment than in the control group. MLRA showed that intervention was significantly related to a lower incidence of LGA infants.


CONCLUSIONS
Our study suggests that maternal BMI impacts fetal growth and that treatment for overweight or obese mothers with OAV is associated with a lower frequency of LGA infants.
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan. Electronic address: tmyka9922@gmail.com.
Takashi
T
Sugiyama
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Hirohito
H
Metoki
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Hirotaka
H
Hamada
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Hidekazu
H
Nishigori
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Masatoshi
M
Saito
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Nobuo
N
Yaegashi
Department of Obstetrics and Gynecology, National Hospital Organization Mie Chuo Medical Center, Tsu, Mie 514-1101, Japan.
Hideto
H
Kusaka
Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
Reo
R
Kawano
Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
Kiyoshi
K
Ichihara
Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki 856-8562, Japan.
Ichiro
I
Yasuhi
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Yuji
Y
Hiramatsu
Department of Obstetrics and Gynecology, Rakuwakai Otowa Hospital, Kyoto 607-8062 Japan.
Norimasa
N
Sagawa
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D047109:Fetal Development; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D007564:Japan / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D015430:Weight Gain
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
Gestational diabetes mellitus (GDM); LGA; Pregnancy outcome; Treatment