Optimal Length of Pregnancy With GDM Questioned

Association of GDM with increased risk of perinatal mortality remains controversial subject


FRIDAY, Feb. 17, 2017 (HealthDay News) -- Adverse perinatal outcomes are higher in insulin-treated gestational diabetes (GDM) than in non-insulin-treated GDM for most outcomes; however, optimal timing of delivery may be earlier than currently recommended, according to a study published online Feb. 15 in Diabetologia.

A team of researchers analyzed data from 796,346 births in France occurring after 28 weeks of pregnancy in 2012, including 57,629 mothers with GDM.

Compared to other pregnant women, those with GDM were 30 percent more likely to experience preterm birth, 40 percent more likely to require a cesarean section, and 70 percent more likely to have preeclampsia/eclampsia. Infants born to women with GDM were 80 percent more likely to be of significantly larger-than-average size at birth, 10 percent more likely to suffer respiratory issues, 30 percent more likely to experience a traumatic birth, and 30 percent more likely to have cardiac malformations. Higher risks were observed in women with insulin-treated GDM compared with diet-treated GDM. In analysis of term deliveries, an increased risk of perinatal mortality was observed, with the risk remaining moderately increased only for those with diet-treated GDM.

"By restricting analysis to deliveries after 37 weeks and excluding cases of undiagnosed pregestational diabetes, we identified a moderate increase in perinatal mortality in non-insulin-treated women with GDM," the authors write. "Although more investigation is needed, this study helps illuminate the controversy about timing of delivery in GDM pregnancy."

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