Categories
Change Password!
Reset Password!
Management of gestational diabetes mellitus diagnosed early in pregnancy leads to a slightly lower incidence of adverse neonatal outcomes when compared to no immediate therapy.
In a landmark study, immediate treatment before 20 weeks' gestation resulted in a modestly lower occurrence of adverse neonatal outcomes compared to deferred treatment. The study, which randomly assigned women with a risk factor for hyperglycemia, aimed to determine whether early intervention could improve maternal and infant health outcomes. The trial encompassed 802 females (between 4 weeks’ and 19 weeks 6 days’ gestation), with 406 receiving immediate therapy and 396 forming the control group (receiving deferred or no therapy).
The study assessed three main outcomes: a combination of negative neonatal events (such as birth before <37 weeks, birth trauma, birth weight of ≥4500 g, respiratory distress, shoulder dystocia, phototherapy, stillbirth or neonatal death), pregnancy-related hypertension (including gestational hypertension, preeclampsia, or eclampsia), and lean body mass of neonates. Initial oral glucose-tolerance tests (OGTT) were conducted at a mean gestation of 15.6 ±2.5 weeks.
The key findings were:
1. Adverse Outcomes for Neonates:
2. Pregnancy-Related Hypertension:
3. Lean Body Mass of Neonates:
There were no discernible variations between the groups concerning significant adverse events correlated with screening and management. Hence, prompt management of gestational diabetes prior to 20 weeks gestation was associated with a modestly diminished risk of adverse neonatal outcomes compared to no immediate treatment. However, no profound differences were observed in pregnancy-connected hypertension or infant lean body mass between the two groups. This research sheds light on the potential benefits of early intervention in gestational diabetes, offering valuable insights for healthcare practitioners and expectant mothers.
The New England Journal of Medicine
Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy
David Simmons et al.
Comments (0)