(HealthDay News) — Immediate treatment of gestational diabetes before 20 weeks of gestation leads to a slightly lower incidence of a composite of adverse neonatal outcomes but no significant difference in pregnancy-related hypertension or neonatal lean body mass, according to a study published online in the New England Journal of Medicine. The research was published to coincide with the 11th International DIP Symposium on Diabetes, Hypertension, Metabolic Syndrome & Pregnancy: Innovative Approaches in Maternal Offspring Health, held from May 4 to 6 in Thessaloniki, Greece.
David Simmons, MD, from Western Sydney University, and colleagues randomly assigned 802 women between 4 weeks and 19 weeks/6 days of gestation who had a risk factor for hyperglycemia and a diagnosis of gestational diabetes to receive immediate treatment or deferred or no treatment for gestational diabetes (406 and 396 women, respectively).
The researchers found that an adverse neonatal outcome event occurred in 24.9 and 30.5% of women in the immediate-treatment and control groups, respectively (adjusted risk difference, −5.6 percentage points; 95% confidence interval, −10.1 to −1.2). Pregnancy-related hypertension occurred in 10.6 and 9.9% in the immediate-treatment and control groups, respectively (adjusted risk difference, 0.7 percentage points; 95 percent confidence interval, −1.6 to 2.9). The mean neonatal lean body mass was 2.86 g and 2.91 g in the immediate-treatment and control groups, respectively (adjusted mean difference, −0.04 g; 95 percent confidence interval, −0.09 to 0.02). With respect to serious adverse events associated with screening and treatment, no between-group differences were observed.
“Confirmatory trials and long-term follow-up studies of the offspring are warranted,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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