المؤلفون: Fidelma Dunne, Breda Kirwan, Oratile Kgosidialwa, Patricia Gunning, Aoife M. Egan, Louise Carmody

المصدر: The Journal of clinical endocrinology and metabolism. 100(12)

مصطلحات موضوعية: obesity, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, body-mass index, outcomes, Biochemistry, Body Mass Index, Fetal Macrosomia, Cohort Studies, Endocrinology, Pregnancy, Obstetrics, Pregnancy Outcome, female genital diseases and pregnancy complications, Exercise Therapy, Gestational diabetes, Treatment Outcome, Infant, Small for Gestational Age, Female, Cohort study, Adult, medicine.medical_specialty, weight-gain, international association, glucose-tolerant women, Internal medicine, Intensive care, Glucose Intolerance, medicine, Fetal macrosomia, Humans, Retrospective Studies, business.industry, Biochemistry (medical), Infant, Newborn, nutritional and metabolic diseases, Retrospective cohort study, Odds ratio, medicine.disease, Hypoglycemia, Diabetes, Gestational, pregnancy study-groups, glycemic control, Intensive Care, Neonatal, atlantic-dip, Small for gestational age, hyperglycemia, business

الوصف: Context: Prevalence of gestational diabetes mellitus (GDM) and obesity continue to increase. Objective: This study aimed to ascertain whether diet and exercise is a successful intervention for women with GDM and whether a subset of these women have comparable outcomes to those with normal glucose tolerance (NGT). Design, Setting, and Participants: This was a retrospective cohort study of five antenatal centers along the Irish Atlantic seaboard of 567 women diagnosed with GDM and 2499 women with NGT during pregnancy. Intervention: Diet and exercise therapy on diagnosis of GDM were prescribed and multiple maternal and neonatal outcomes were examined. Results: Infants of women with GDM were more likely to be hypoglycemic (adjusted odds ratio [aOR], 7.25; 95% confidence interval [CI], 2.94-17.9) at birth. They were more likely to be admitted to the neonatal intensive care unit (aOR, 2.16; 95% CI, 1.60-2.91). Macrosomia and large-forgestational-age rates were lower in the GDM group (aOR, 0.48; 95% CI, 0.37-0.64 and aOR, 0.61; 95% CI, 0.46-0.82, respectively). There was no increase in small for gestational age among offspring of women with GDM (aOR, 0.81; 95% CI, 0.49-1.34). Women with diet-treated GDM and body mass index (BMI)

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3b641d8751200c38e402141ec84fa334Test
https://pubmed.ncbi.nlm.nih.gov/26495752Test

المؤلفون: Delia Bogdanet, Breda Kirwan, Oratile Kgosidialwa, Catriona Reddin, Fidelma Dunne, Aoife M. Egan, Louise Carmody

المصدر: The Journal of Clinical Endocrinology & Metabolism. :jc.2016-2911

مصطلحات موضوعية: Male, Neonatal intensive care unit, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Biochemistry, Infant, Newborn, Diseases, Fetal Macrosomia, Cohort Studies, 0302 clinical medicine, Endocrinology, Pre-Eclampsia, Pregnancy, Odds Ratio, Insulin, 030212 general & internal medicine, Obstetrics, Gestational diabetes, Infant, Small for Gestational Age, Female, Cohort study, Adult, Polyhydramnios, medicine.medical_specialty, 030209 endocrinology & metabolism, 03 medical and health sciences, Intensive Care Units, Neonatal, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Retrospective Studies, business.industry, Postpartum Hemorrhage, Biochemistry (medical), Infant, Newborn, Case-control study, nutritional and metabolic diseases, Retrospective cohort study, Hypertension, Pregnancy-Induced, medicine.disease, Hypoglycemia, Pregnancy Complications, Diabetes, Gestational, Logistic Models, Case-Control Studies, Multivariate Analysis, Small for gestational age, Uterine Hemorrhage, business

الوصف: Approximately 40% of women with gestational diabetes mellitus (GDM) diagnosed using International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria require insulin therapy.We assessed whether the outcomes for women with GDM treated with insulin are comparable to women with normal glucose tolerance (NGT).This retrospective cohort study included 752 women with insulin-treated GDM and 2496 women with NGT during pregnancy. Maternal and fetal outcomes were examined.Infants of women with insulin-treated GDM had rates of macrosomia [adjusted odds ratio (aOR), 1.19; 95% confidence interval (CI), 0.87 to 1.63; P = 0.26], large for gestational age (LGA) (aOR, 1.07; 95% CI, 0.77 to 1.47; P = 0.67), and small for gestational age (SGA) (aOR, 0.70; 95% CI, 0.38 to 1.38; P = 0.26) similar to women with NGT. They were more likely to be hypoglycemic at birth (aOR, 6.85; 95% CI, 2.31 to 20.28; P0.01) and to require neonatal intensive care unit care (NICU) (aOR, 12.09; 95% CI, 8.72 to 16.76; P0.01), predominantly for nonmedical reasons. Maternal rates of hypertensive disorders (preeclampsia: aOR, 0.64; 95% CI, 0.34 to 1.12; P = 0.17; pregnancy-induced hypertension: aOR, 1.11; 95% CI, 0.74 to 1.66; P = 0.60) and hemorrhage (ante partum hemorrhage: aOR, 0.56; 95% CI, 0.19 to 1.58; P = 0.27; postpartum hemorrhage: aOR, 1.17; 95% CI, 0.68 to 2.03; P = 0.55) were similar between groups, but the risk of polyhydramnios was increased in the GDM cohort (aOR, 7.75; 95% CI, 3.96 to 15.16; P0.01).Insulin treatment of IADPSG-diagnosed GDM results in rates of macrosomia, LGA, SGA, and maternal hypertensive disorders similar to those of women with NGT. Although NICU admissions are greater in the GDM cohort, they are primarily for nonmedical reasons. Neonatal hypoglycemia and polyhydramnios remain greater among women with insulin-treated GDM.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::670fa0cc5f83e912b15005c56237a642Test
https://doi.org/10.1210/jc.2016-2911Test