TY - CHAP
T1 - Interventions for pregnant women with hyperglycaemia not meeting GDM and T2DM diagnostic criteria: A cochrane review
AU - Han, Shan
AU - Crowther, Caroline A.
AU - Middleton, Philippa
PY - 2011
Y1 - 2011
N2 - Background: Even very mild forms of hyperglycaemia during pregnancy are associated with adverse outcomes, including macrosomia, preeclampsia and caesarean section. This study aimed to assess the effects of treatment for pregnant women with hyperglycaemia not meeting diagnostic criteria for GDM and T2DM on pregnancy outcomes. Method: We used standard Cochrane methodology (last search November 2010). Results: Three small trials, with high risk of bias, randomised 509 women with hyperglycaemia not meeting GDM and T2DM diagnostic criteria to either treatment (dietary advice, metabolic monitoring, and insulin therapy if necessary) or routine care. Compared with babies born to women receiving routine care, babies born to women in the treatment group had a lower birth weight (average MD -147.08 g, 95% CI -270.48 to -23.67, random effects, three trials, 509 infants); a lower ponderal index (MD -0.09, 95% CI -0.16 to -0.02, one trial, 300 infants); and were less likely to be large for gestational age (RR 0.36, 95% CI 0.20 to 0.66, two trials, 426 infants) and macrosomic (RR 0.38, 95% CI 0.19 to 0.74, two trials, 426 infants). Caesarean section rates were not significantly different between the two groups (RR 0.93, 95% CI 0.68 to 1.27, three trials, 509 women). Conclusions: Although results from three, small, randomised trials suggest benefit, larger trials are needed with sufficient power to assess the effects of lifestyle advice and metabolic monitoring on maternal and infant health outcomes.
AB - Background: Even very mild forms of hyperglycaemia during pregnancy are associated with adverse outcomes, including macrosomia, preeclampsia and caesarean section. This study aimed to assess the effects of treatment for pregnant women with hyperglycaemia not meeting diagnostic criteria for GDM and T2DM on pregnancy outcomes. Method: We used standard Cochrane methodology (last search November 2010). Results: Three small trials, with high risk of bias, randomised 509 women with hyperglycaemia not meeting GDM and T2DM diagnostic criteria to either treatment (dietary advice, metabolic monitoring, and insulin therapy if necessary) or routine care. Compared with babies born to women receiving routine care, babies born to women in the treatment group had a lower birth weight (average MD -147.08 g, 95% CI -270.48 to -23.67, random effects, three trials, 509 infants); a lower ponderal index (MD -0.09, 95% CI -0.16 to -0.02, one trial, 300 infants); and were less likely to be large for gestational age (RR 0.36, 95% CI 0.20 to 0.66, two trials, 426 infants) and macrosomic (RR 0.38, 95% CI 0.19 to 0.74, two trials, 426 infants). Caesarean section rates were not significantly different between the two groups (RR 0.93, 95% CI 0.68 to 1.27, three trials, 509 women). Conclusions: Although results from three, small, randomised trials suggest benefit, larger trials are needed with sufficient power to assess the effects of lifestyle advice and metabolic monitoring on maternal and infant health outcomes.
KW - Australia and New Zealand
KW - diagnosis
KW - female
KW - human
KW - hyperglycemia
KW - pregnant woman
KW - society
KW - adverse outcome
KW - baby
KW - birth weight
KW - cesarean section
KW - fenfluramine
KW - health
KW - infant
KW - insulin treatment
KW - large for gestational age
KW - lifestyle
KW - macrosomia
KW - methodology
KW - monitoring
KW - preeclampsia
KW - pregnancy
KW - pregnancy outcome
KW - risk
M3 - Chapter
SN - 1034-4810
T3 - Journal of Paediatrics and Child Health
SP - 11
BT - Journal of Paediatrics and Child Health
PB - Blackwell Publishing
CY - S. Han, ARCH: Australian Research Centre for Health of Women and Babies, Robinson Institute, University of Adelaide, Adelaide, Australia. E-mail: [email protected]
ER -