Gestational diabetes & diabetes in pregnancy
Perinatal Outcomes in Early and Late Gestational Diabetes Mellitus After Treatment From 24–28 Weeks’ Gestation: A TOBOGM Secondary Analysis
Authors' conclusion
Adverse perinatal outcomes were increased with EGDM despite treatment from 24-28 weeks' gestation, suggesting the need to initiate treatment early, and more aggressively, to reduce the effects of exposure to the more severe maternal hyperglycemia from early pregnancy.
Study context
- Population
- Women with risk factors for gestational diabetes mellitus (GDM) (WHO 2013 criteria); those receiving early GDM treatment excluded; GDM treated if present at 24–28 weeks
- Participants
- 254 / 467 / 2,339
- Comparison
- Early GDM and late GDM vs normoglycaemia at 24–28 weeks
- EGDMn = 254
- LGDMn = 467
- Controln = 2,339reference
- Primary endpoint
- Composite of:
- Birth <37 weeks
- Birth weight ≥4,500 g
- Birth trauma
- Neonatal respiratory distress
- Phototherapy
- Stillbirth/neonatal death
- Shoulder dystocia
Primary result
As reported in the abstract
Composite perinatal outcome
Each group vs controlOdds ratio (95% CI)
EGDM
1.59(1.18–2.12)
LGDM
1.19(0.94–1.50)
Further findings
- Shorter pregnancy duration with EGDM and LGDM vs control participants
- BMI lowest with LGDM
- Induction of labour higher in both GDM groups
- Higher birth centile, preterm birth rate and neonatal jaundice rate with EGDM (not LGDM) vs control participants
- Greatest need for insulin and/or metformin with EGDM
Original publication
Perinatal Outcomes in Early and Late Gestational Diabetes Mellitus After Treatment From 24–28 Weeks’ Gestation: A TOBOGM Secondary Analysis. Diabetes Care. Published 29 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →