Treating diabetes pregnant reduces serious birthing problems

Treating pregnant women for mild gestational diabetes resulted in fewer cesarean sections and other serious birthing problems associated with larger than average babies, revealed by US researchers.

This study is conducted in part at the University of North Carolina at Chapel Hill. The study is published in the Oct. 1 issue of the New England Journal of Medicine.

The lead author and principal investigator is Mark B. Landon, M.D. of Ohio State University. It was conducted at 14 sites that are part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network.

About 4% of all pregnant women in the US develop gestational diabetes, resulting in about 135,000 cases each year. Because these women have high blood sugar levels, their babies receive more blood glucose than they need, and the extra energy is stored as fat.

These babies tend to be larger and fatter than average at birth and thus are more likely to be affected by problems associated with larger babies, such as the need for cesarean delivery, damage to their shoulders during birth and a greater risk of becoming obese as children and developing type 2 diabetes as adults.

The MFMU Network launched a clinical trial to determine if treating mothers for mild gestational diabetes would reduce infant deaths and birth-related complications. A total of 958 women between 24 and 31 weeks of pregnancy were randomized, with 485 receiving treatment (including dietary changes, self blood glucose monitoring and insulin if necessary) and 473 in the untreated group.

There were no infant deaths in the study and no significant differences between the two groups in terms of babies born with problems such as hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia and birth trauma.

However, there were significantly fewer babies in the treatment group to experience unusually large size (7.1 percent vs. 14.5 percent), high birth weight (5.9 percent vs. 14.3 percent), shoulder damage during birth (1.5 percent vs. 4.0 percent) or to require cesarean delivery (26.9 percent vs. 33.8 percent).

The study concludes that “these findings confirm a benefit to the identification and treatment of women with mild carbohydrate intolerance during pregnancy.”

Source: University of North Carolina School of Medicine, USA



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