title: Investigating the effects of treatment based on single high blood glucose in gestational diabetes screening on maternal and neonatal complications.
abstract: OBJECTIVE
  To create a positive step toward achieving an efficient method for gestational diabetes treatment, the present study was carried out to compare the treatment outcomes based on single impaired blood glucose versus regular method in health care centers in Iran.
  
  
  METHODS
  This randomized clinical trial was carried out in Tehran/Iran between March 2012 and August 2013. Study sample consisted of mothers whose fasting blood sugar was disturbed or a disturbed blood sugar was seen in OGTT with 75 g glucose load, according to ADA standards. For each outcome, multiple logistic regressions were used to control for the effects of potential confounders. When a confounder was measured on a continuous scale (e.g., age), LOWESS (locally weighted scatter plot smoothing) algorithm was used to determine whether the effect of that variable was linear. We also used the fractional polynomial regression to determine the optimal transformation of continuous covariates.
  
  
  RESULTS
  The information of 189 pregnant women was used in this study; 87 in the interventional group (46 %) and 102 in the control group (54 %). Treatment based on the new protocol has very high protective effect (OR 0.25, 95 % CI 0.68-0.88) in terms of neonatal hyperbilirubinemia. This difference was not seen in other outcomes including stillbirth, macrosomic newborn delivery, hypoglycemia, and hypocalcemia. The risk of neonatal hypoglycemia reduced after the 25th week of gestation (OR 0.39, 95 % CI 0.15-0.98).
  
  
  CONCLUSIONS
  Although the treatment of mild gestational diabetes could not significantly decrease severe neonatal outcomes, it did significantly reduce the risk of hyperbilirubinemia and its subsequent complications.
authors.affiliation: Department of Perinatology, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Mirzamoradi
authors.forename: Mahmood
authors.initials: M
authors.lastname: Bakhtiyari
authors.forename: Parichehr
authors.initials: P
authors.lastname: Kimiaee
authors.forename: Azadeh
authors.initials: A
authors.lastname: Hosseini-Najarkolaei
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mansournia
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007231:Infant, Newborn; D007492:Iran; D016015:Logistic Models; D008403:Mass Screening; D011247:Pregnancy; D011256:Pregnancy Outcome; D050497:Stillbirth; D055815:Young Adult
chemical_list: D001786:Blood Glucose