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Pregnancy outcome in women with gestational diabetes: results of a four-year audit
Practical Diabetes, 08/09/2012
Basu A et al. – It was concluded that good metabolic control is essential for successful pregnancy outcomes. The use of insulin does not appear to alter the maternal–fetal outcome in women with gestational diabetes mellitus (GDM).
Methods- The authors undertook a retrospective audit of clinical practice comprising 416 consecutive women with GDM and live singleton pregnancies who delivered over a four-year period.
- Pregnancy outcome measures were compared for women on diet/lifestyle advice only versus those requiring additional insulin in line with standard clinical practice.
- The results showed that 46.9% of women with GDM were in the diet/lifestyle group and 53.1% were in the additional insulin therapy group; 45.3% were found to be obese.
- Good glycaemic control was achieved in both groups – mean pre-delivery HbA1c was 41mmol/mol in the diet/lifestyle group versus 46mmol/mol in the insulin group (p<0.001).
- There was no statistically significant difference in the majority of the pregnancy outcome measures between the two groups.
- Those on diet-only had a lower caesarean section rate (OR 0.39; 95% CI 0.26–0.58; p<0.001), a higher chance of vaginal birth (OR 2.40; 95% CI 1.62–3.56; p<0.001) and a lower chance of pre-term labour (OR 0.49; 95% CI 0.31–0.76; p=0.001).
