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Treating Gestational Diabetes Can Reduce Fetal Overgrowth

Last Updated: September 30, 2009.

Treatment of mild gestational diabetes mellitus in pregnant women did not significantly affect stillbirth or perinatal death, but did reduce the risk of fetal overgrowth, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

WEDNESDAY, Sept. 30 (HealthDay News) -- Treatment of mild gestational diabetes mellitus in pregnant women did not significantly affect stillbirth or perinatal death, but did reduce the risk of fetal overgrowth, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

Mark B. Landon, M.D., of Ohio State University in Columbus, and colleagues randomized 958 women with gestational diabetes to a regimen of insulin therapy, diet, and glucose self-monitoring, or to a control group receiving usual prenatal care. The primary outcome was a composite score including stillbirth, perinatal death, and neonatal complications. Secondary outcomes included variables of the birth and the newborn, such as mode of delivery and birth weight.

The researchers found that the incidence of the composite outcome was comparable in the treatment and control groups (32.4 and 37.0 percent, respectively). However, the treated group had better secondary outcomes compared to controls: mean birth weight (3,302 versus 3,408 grams), large-for-gestational-age newborns (7.1 versus 14.5 percent), shoulder dystocia (1.5 versus 4.0 percent), reduced preeclampsia/hypertension (8.6 versus 13.6 percent), and cesarean birth (26.9 versus 33.8 percent).

"Although the primary composite outcome in our trial was not significantly reduced with treatment, the results of our study provided further compelling evidence that among women who have gestational diabetes mellitus and normal fasting glucose levels, treatment that includes dietary intervention and insulin therapy, as necessary, reduces rates of fetal overgrowth, cesarean delivery, and preeclampsia," the authors write.

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