Effect of treatment for early gestational diabetes mellitus on neonatal respiratory distress: A secondary analysis of the TOBOGM study.
diagnostic criteria
early gestational diabetes mellitus
first trimester
gestational diabetes mellitus
neonatal intensive care
neonatal respiratory distress
pregnancy
screening
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
19 Aug 2024
19 Aug 2024
Historique:
revised:
15
07
2024
received:
19
02
2024
accepted:
09
08
2024
medline:
19
8
2024
pubmed:
19
8
2024
entrez:
19
8
2024
Statut:
aheadofprint
Résumé
To identify factors associated with neonatal respiratory distress (NRD) in early Gestational diabetes mellitus (eGDM). Nested case-control analysis of the TOBOGM trial. Seventeen hospitals: Australia, Sweden, Austria and India. Pregnant women, <20 weeks' gestation, singleton, GDM risk factors. Women with GDM risk factors completed an oral glucose tolerance test (OGTT) before 20 weeks: those with eGDM (WHO-2013 criteria) were randomised to immediate or deferred GDM treatment. Logistic regression compared pregnancies with/without NRD, and in pregnancies with NRD, those with/without high-dependency nursery admission for ≤24 h with those admitted for >24 h. Comparisons were adjusted for age, pre-pregnancy body mass index, ethnicity, smoking, primigravity, education and site. Adjusted odds ratios (95% CI) are reported. NRD definition: ≥4 h of respiratory support (supplemental oxygen or supported ventilation) postpartum. Respiratory distress syndrome (RDS): Supported ventilation and ≥24 h nursery stay. Ninety-nine (12.5%) of 793 infants had NRD; incidence halved (0.50, 0.31-0.79) if GDM treatment was started early. NRD was associated with Caesarean section (2.31, 1.42-3.76), large for gestational age (LGA) (1.83, 1.09-3.08) and shorter gestation (0.95, 0.93-0.97 per day longer). Among NRD infants, >24 h nursery-stay was associated with higher OGTT 1-h glucose (1.38, 1.08-1.76 per mmol/L). Fifteen (2.0%) infants had RDS. Identifying and treating eGDM reduces NRD risk. NRD is more likely with Caesarean section, LGA and shorter gestation. Further studies are needed to understand the mechanisms behind this eGDM complication and any long-term effects.
Identifiants
pubmed: 39157877
doi: 10.1111/1471-0528.17938
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Region Örebro Research Committee
ID : OLL-970566
Organisme : Region Örebro Research Committee
ID : OLL-942177
Organisme : National Health and Medical Research Council
ID : 1104231
Organisme : National Health and Medical Research Council
ID : 2009326
Organisme : Western Sydney University Ainsworth Trust Grant
Organisme : Medical Scientific Fund of the Mayor of Vienna
ID : 15205
Organisme : Medical Scientific Fund of the Mayor of Vienna
ID : 23026
Organisme : South Western Sydney Local Health District Academic Unit
Investigateurs
Raiyomand Dalal
(R)
Georgia Soldatos
(G)
Suja Padmanabhan
(S)
Rohit Rajagopal
(R)
Victoria Rudland
(V)
Herbert Kiss
(H)
Erik Schwarcz
(E)
Ranjit Mohan Anjana
(RM)
Uma Ram
(U)
Informations de copyright
© 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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