title: Neonatal outcomes according to different therapies for gestational diabetes mellitus.
abstract: OBJECTIVE
  To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus.
  
  
  METHODS
  This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5min, and need for intensive care unit admission.
  
  
  RESULTS
  The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66) and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94). Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78). The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15) and lower chance to be born preterm (95% CI: 0.01-0.71). The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission.
  
  
  CONCLUSIONS
  The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received.
authors.affiliation: Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil. Electronic address: Mandinha4265@hotmail.com.
authors.forename: Amanda L da
authors.initials: AL
authors.lastname: Silva
authors.affiliation: Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil.
authors.forename: Augusto R do
authors.initials: AR
authors.lastname: Amaral
authors.affiliation: Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil.
authors.forename: Daniela S de
authors.initials: DS
authors.lastname: Oliveira
authors.affiliation: Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil.
authors.forename: Lisiane
authors.initials: L
authors.lastname: Martins
authors.affiliation: Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil.
authors.forename: Mariana R E
authors.initials: MR
authors.lastname: Silva
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Jean Carl
authors.initials: JC
authors.lastname: Silva
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin
keywords: Desfechos; Diabetes mellitus gestacional; Gestational diabetes mellitus; Outcomes; Therapeutics; Tratamento