Diet or medically treated gestational diabetes: is there any difference for obstetrical and neonatal complications? A French cohort study

Audrey Blachier; Corinne Alberti; Diane Korb; Thomas Schmitz; Vexiau Patrick; Boissinot Christine; Jean-François Oury; Olivier Sibony

doi:10.1515/jpm-2013-0079

Article

Diet or medically treated gestational diabetes: is there any difference for obstetrical and neonatal complications? A French cohort study

Audrey Blachier , Corinne Alberti , Diane Korb , Thomas Schmitz , Vexiau Patrick , Boissinot Christine , Jean-François Oury and Olivier Sibony

Published/Copyright: November 16, 2013

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From the journal Journal of Perinatal Medicine Volume 42 Issue 3

Abstract

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 (OR_nonscheduled=2.3; 95% CI: 1.6–3.3; P<0.001) while DTGD was not (OR_nonscheduled=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.

Keywords: Complications; diet; gestational diabete

Corresponding author: Pr. Olivier Sibony, Service de gynécologie-obstétrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 48 Boulevard Sérurier, 75019 Paris, France, Tel.: +33 1 40 03 24 54, Fax: +33 1 40 03 53 76, E-mail: olivier.sibonyr@rdb.aphp.fr

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-4-10

Accepted: 2013-10-9

Published Online: 2013-11-16

Published in Print: 2014-5-1

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https://doi.org/10.1515/jpm-2013-0079

Keywords for this article

Complications; diet; gestational diabete