Early gestational diabetes tied to poor outcomes

(HealthDay)—Diagnosis of gestational diabetes mellitus (GDM) early in pregnancy remains associated with poorer pregnancy outcomes, according to a study published online Dec. 8 in Diabetes Care.

Arianne N. Sweeting, Ph.D., from the Royal Prince Alfred Hospital in Sydney, and colleagues retrospectively evaluated outcomes for 4,873 women attending a university hospital antenatal diabetes clinic between 1991 and 2011. Women were classified as pre-existing diabetes (65 patients) or GDM diagnosed at <12 weeks of gestation (68 patients), at 12 to 23 weeks of gestation (1,247 patients), or at ≥24 weeks of gestation (3,493 patients).

The researchers found that women with pre-existing diabetes and early GDM had a higher prevalence of hypertensive disorders in pregnancy, including pre-eclampsia, preterm delivery, cesarean section, and neonatal jaundice (all P < 0.001). Rates of macrosomia (P = 0.8), large for gestational age (P = 0.4), and neonatal intensive care admission (P = 0.9) were comparable in women diagnosed with GDM at <12 weeks of gestation and women with pre-existing diabetes.

"These findings indicate the need for further studies to establish the efficacy of alternative management approaches to improve outcomes in these high-risk pregnancies," the authors write.