title: Antenatal management of gestational diabetes mellitus can improve neonatal outcomes.
abstract: OBJECTIVE
  Pregnancies complicated with gestational diabetes mellitus (GDM) are at a higher risk for caesarean and instrumental deliveries as well as adverse neonatal outcomes such as fetal overgrowth, hypoglycaemia and neonatal intensive care admission. Our primary objective was to describe neonatal outcomes in a sample that included term infants of both GDM mothers and mothers with normal glucose tolerance (NGT).
  
  
  METHODS
  this cross-sectional study included 599 term babies born between September and October 2010 at Royal Prince Alfred Hospital, Sydney, Australia. Maternal and neonatal data were collected from medical records and a questionnaire. Glycaemic control data was based on third trimester HbA1c levels and self-monitoring blood glucose levels (BGL). Univariate associations between GDM status and maternal demographic factors, as well as pregnancy outcomes, were estimated using χ(2) tests and t-tests, as appropriate.
  
  
  RESULTS
  of 599 babies, 67(11%) were born to GDM mothers. GDM mothers were more likely to be overweight/obese and of Asian ethnicity. Good glycaemic control was achieved in most GDM mothers. GDM babies were more likely to have been induced (p=0.013) and delivered earlier than non-GDM mothers (p<0.001), and they were also more likely to be breastfed within one hour of birth.
  
  
  CONCLUSIONS
  in this study, GDM infants were more likely to be induced and delivered earlier but otherwise they did not have significantly different neonatal outcomes compared to infants of NGT mothers. This can be attributed to the good GDM control by lifestyle modification and insulin if necessary. The role of labour induction in GDM pregnancies should be further investigated. Midwives have an important role in maternal education during pregnancy and in the postnatal period.
authors.affiliation: Sydney Eye Hospital, Sydney, Australia. Electronic address: cheryl.au@gmail.com.
authors.forename: Cheryl Pui Yan
authors.initials: CPY
authors.lastname: Au
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Camille H
authors.initials: CH
authors.lastname: Raynes-Greenow
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Turner
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Angela E
authors.initials: AE
authors.lastname: Carberry
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia; Newborn Care, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Jeffery
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000451:nursing / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000451:nursing / Q000517:prevention & control; D008297:Male; D008880:Midwifery; D009517:New South Wales / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care
keywords: Breastfeeding; Gestational diabetes mellitus; Hyperglycaemia; Induction; Labour; Neonatal outcomes