Poor control of gestational diabetes harms fetus

NEW YORK (Reuters Health) - Research shows that poor control of blood sugar levels in women with pregnancy-related or "gestational" diabetes is associated with several adverse infant outcomes. These include delivering an abnormally large infant, a condition called "macrosomia" and delivering an infant with "hypoglycemia" or low blood sugar.

These findings, the authors say, suggest that "careful monitoring" of blood sugar levels and initiation of appropriate treatment are "essential in the care of women with gestational diabetes."

Dr. Victor Hugo Gonzalez-Quintero, from the University of Miami, and colleagues studied 3,218 women who were pregnant with a single fetus and who were enrolled in an outpatient gestational diabetes management program.

According to the team, more than one third of infants born to women with poorly controlled blood sugar had one or more adverse outcomes compared with 24 percent of infants born to women with good blood sugar control.

The researchers defined adverse outcome as a composite variable including macrosomia, large-for-gestational age, hypoglycemia, jaundice and stillbirth.

In terms of individual conditions, uncontrolled blood sugar levels were significantly associated with macrosomia, large-for-gestational age, and infant low blood sugar, but not with jaundice or stillbirth.

Treatment in the intensive care unit and deliver by cesarean section were also more common among infants of mothers with inadequately controlled blood sugar control.

SOURCE: Diabetes Care March 2007.