Journal of Perinatal Medicine
Official Journal of the World Association of Perinatal Medicine
Editor-in-Chief: Dudenhausen, Joachim W.
Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland
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Diet or medically treated gestational diabetes: is there any difference for obstetrical and neonatal complications? A French cohort study
1Département d’information médicale, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 48 Boulevard Sérurier, 75019, Paris, France
2Unité d’épidémiologie clinique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris and Université Paris 7 Denis Diderot, 48 Boulevard Sérurier, 75019, Paris, France
3Université Paris Diderot, Sorbonne Paris Cité, Unité d’Épidémiologie Clinique, Paris, France
4INSERM, CIE 5, Paris, France
5Université Paris 7 Denis Diderot, UFR de Médecine, Paris, France
6Service de gynécologie-obstétrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 48 Boulevard Sérurier, 75019, Paris, France
7Service d’endocrinologie et de diabétologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, 1 avenue Claude-Vellefaux, 75010, Paris, France
Citation Information: Journal of Perinatal Medicine. Volume 42, Issue 3, Pages 315–319, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm-2013-0079, November 2013
- Published Online:
Objective: The aim of the present study was to determine specific obstetrical and neonatal complications associated with diet-treated gestational diabetes (DTGD) and medically treated gestational diabetes (MTGD).
Methods: This is a prospective cohort study of women followed in the Robert Debré Hospital (France, Paris) and who have given birth between 1 January, 2004, and 19 November, 2010. Clinical, biological, maternal and neonatal data were reported in the maternity database. Associations between obstetrical and neonatal complications and gestational diabetes were evaluated by estimating odd ratios (ORs) and their 95% CIs, using a logistic regression model.
Results: 16,244 pregnancies were included in the study. 1515 (9.3%) women had gestational diabetes: 1108 (7.3%) had DTGD, 243 (1.7%) had MTGD. After full adjustment, MTGD was associated with an increased risk of nonscheduled cesarean (ORnonscheduled=2.3; 95% CI: 1.6–3.3; P<0.001) while DTGD was not (ORnonscheduled=1.0; 95% CI: 0.8–1.3; P<0.96). Clinical macrosomia was positively associated with DTGD (OR=2; 95% CI: 1.7–2.4; P<0.0001) or MTGD (OR=2.9; 95% CI: 2.1–3.9; P<0.0001).
Conclusion: This study confirms that macrosomia is the main complication of DTGD. By contrast, DTGD was not associated with neonatal hypoglycemia and cesarean, while these complications were associated with MTGD.