The Impact of Glycemic Control on Neonatal Outcome in Singleton Pregnancies Complicated by Gestational Diabetes
- Víctor Hugo González-Quintero, MD, MPH1,
- Niki B. Istwan, RN2,
- Debbie J. Rhea, MPH2,
- Lorna I. Rodriguez, MD1,
- Amanda Cotter, MD1,
- Jena Carter, MD1,
- Antoaneta Mueller, MD1 and
- Gary J. Stanziano, MD2
- 1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Miami, Miami, Florida
- 2Clinical Research Department, Matria Healthcare, Marietta, Georgia
- Address correspondence to Víctor Hugo González-Quintero, MD, MPH, Department of Obstetrics and Gynecology, University of Miami, P.O. Box 016960 (R-136), Miami, FL 33101. E-mail: vhgonzalez{at}med.miami.edu
Abstract
OBJECTIVE—To identify the impact of suboptimal blood glucose control on neonatal outcomes in women with gestational diabetes mellitus (GDM).
RESEARCH DESIGN AND METHODS—Included were patients with singleton gestation enrolled in an outpatient GDM management program for at least 7 days who delivered at term. Blood glucose control was defined as an average fasting blood glucose of <95 mg/dl, 1-h postprandial of <140 mg/dl, or 2-h postprandial of <120 mg/dl. Data were compared between patients with optimal blood glucose control (n = 2,030) and those with suboptimal blood glucose control (n = 1,188). The primary study outcome was a composite variable consisting of macrosomia, large-for-gestational-age, hypoglycemia, jaundice, or stillbirth.
RESULTS—Over one-third of infants in the poorly controlled group were positive for at least one factor comprising the composite variable compared with 24% from the controlled group (P < 0.001).
CONCLUSIONS—Suboptimal glycemic control in women with GDM is associated with adverse neonatal outcome. Careful monitoring of blood glucose levels and initiation of appropriate treatment are essential in the care of women with GDM.
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted December 8, 2006.
- Received September 7, 2006.
- DIABETES CARE
