 Risk of perinatal death was increased by 30%, compared with the risk in non-diabetic mothers, in mothers with gestational diabetes who gave birth after 37 weeks, a large new cohort study from France shows.
This higher risk of the baby dying was the same regardless of whether the woman was treated with insulin for the gestational diabetes or not. However, it was still lower than the risk of perinatal death in mothers with either type 1 diabetes or type 2 diabetes, reported Sophie Jacqueminet, MD, senior investigator from Hôpital Pitié-Salpétrière, Paris, France, presenting the results at the European Association for the Study of Diabetes (EASD) 2016 Annual Meeting. She highlighted the significance of this finding for women with gestational diabetes. "This increase in perinatal death, particularly in women with untreated gestational diabetes that we see here, is new. It is often thought that those with untreated gestational diabetes are less severe and might have lower risk of poor perinatal outcome," she said. "It's also important to know the risk at the end of pregnancy, because the recommendation regarding induction of labor at this time is unclear." However, Dr Jacqueminet also highlighted that it would be important to determine whether the effect seen was secondary to obesity, poor glycemic control, lack of appropriate care, and/or long-term exposure to hyperglycemia. Chairing the session, Elisabeth Mathiesen, MD, from the University Hospital of Copenhagen, Rigshospitalet, Denmark, pointed out that the study is likely to be the first that has investigated the risk associated with gestational diabetes in pregnancy continuing beyond week 37. "I like the way you have explored your data and presented this very clearly. We already know the risk of macrosomia and we try to manage this. The worst thing that can happen in the delivery room is the death of a baby, so I appreciate that you have looked into this," she said. (The above article was pulished at MedScape.com on 15 Sep 2016)
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