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| |  Treating Even Mild Gestational Diabetes Reduces Birth Complications BETHESDA, Md -- October 1, 2009 -- A study published in the October 1 issue of the New England Journal of Medicine provides the first conclusive evidence that treating pregnant women who have even the mildest form of gestational diabetes can reduce the risk of common birth complications among infants, as well as blood pressure disorders among mothers. Treatment of severe gestational diabetes is known to benefit mothers and infants. Although treatment is routinely prescribed for all women with gestational diabetes, before the current study, there was no evidence to show whether treating the mild form of the condition benefited, or posed risks for, mothers or their infants. The researchers found that, compared with the women’s untreated counterparts, women treated for mild gestational diabetes had smaller, leaner babies less likely to be overweight or abnormally large, and less likely to experience shoulder dystocia. Treated mothers were also less likely to undergo cesarean delivery, to develop high blood pressure during pregnancy, or to develop preeclampsia. The study was conducted by researchers in the Maternal Fetal Medicine Units Network of the National Institutes of Health’s s Eunice Kennedy Shriver National Institute of Child Health and Human (NICHD), Bethesda, Maryland. “Whether to treat mild gestational diabetes has never been entirely clear,” said study coauthor Catherine Y. Spong, c Pregnancy and Perinatology Branch at the NICHD. “The study results show conclusively that both mothers and infants do better when gestational diabetes is controlled.” The study included 958 women with mild gestational diabetes. Roughly half were treated for their diabetes and half were not, receiving only standard pregnancy care. The researchers defined mild gestational diabetes as having normal blood sugar levels after fasting but abnormally high levels in at least 2 readings over the course of 3 hours after an oral glucose tolerance test. Severe diabetes was defined as high blood sugar levels even after fasting. In their statistical analysis of the study results, the researchers combined several serious potential outcomes into 1 figure, to represent a single and primary outcome. The primary outcome consisted of all cases of newborn death, stillbirth, newborns with low blood sugar or with high insulin levels, birth-related injuries, and high bilirubin levels. In terms of the primary outcome, there were no differences between the 2 groups of women. But the women who received treatment fared significantly better than the untreated women on other measures. Specifically, compared to women who did not receive treatment, those who did were half as likely to have an unusually large baby; half as likely to experience shoulder dystocia during childbirth; four-fifths as likely to give birth by cesarean section; and three-fifths as likely to develop high blood pressure or preeclampsia. SOURCE: National Institutes of Health
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