Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Diagnosis and Management of GDM
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Study Population and Demographics
3.2. Glycaemic Control
3.3. Perinatal Outcomes
4. Discussion
Author Contributions
Conflicts of Interest
References
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Maternal Characteristics | Metformin (n = 83) | Insulin (n = 83) | Diet and Lifestyle (n = 83) | p |
---|---|---|---|---|
Maternal age (years) | 33.1 ± 4.8 | 33.5 ± 4.3 | 33.1 ± 4.3 | 0.858 |
Ethnicity | ||||
Caucasian | 41.0% (n = 34) | 30.1% (n = 25) | 37.3% (n = 31) | 0.261 |
South Asian | 26.5% (n = 22) | 34.9% (n = 29) | 18.1% (n = 15) | - |
Asian | 21.7% (n = 18) | 24.1% (n = 20) | 32.5% (n = 27) | - |
South-East Asian | 7.2% (n = 6) | 6.0% (n = 5) | 9.6% (n = 8) | - |
Middle Eastern | 2.4% (n = 2) | 4.8% (n = 4) | 1.2% (n = 1) | - |
Pacific Islander | 1.2% (n = 1) | 0 | 0 | - |
African | 0 | 0 | 1.2% (n = 1) | - |
Previous GDM | 13.3% (n = 11) | 13.3% (n = 11) | 13.3% (n = 11) | 0.999 |
Diagnosis of GDM (weeks) | 23.6 ± 5.9 | 24.0 ± 5.8 | 24.0 ± 5.7 | 0.880 |
Maternal BMI (kg/m2) | 27.8 ± 8.0 | 25.2 ± 6.3 | 22.7 ± 2.9 | <0.0001 |
Family history of diabetes | 42.2% (n = 35) | 48.2% (n = 40) | 39.8% (n = 33) | 0.528 |
Gestational age at initiation of pharmacotherapy (weeks) | 27.1 ± 5.7 | 28.0 ± 5.4 | N/A | 0.292 |
Gestational age at initiation of supplemental insulin (weeks) | 29.5 ± 5.7 | N/A | N/A | - |
Total daily dose of insulin in units (before delivery) | 23.6 ± 19.6 | 26.9 ± 24.2 | N/A | 0.779 |
Perinatal Outcomes | Metformin (n = 83) | Insulin (n = 83) | Diet and Lifestyle (n = 82) | p |
---|---|---|---|---|
Maternal Outcomes | ||||
Mode of Delivery | ||||
Vaginal | 38.6% (n = 32) | 50.6% (n = 42) | 53.7% (n = 44) | 0.268 |
Instrumental | 19.3% (n = 16) | 19.3% (n = 16) | 13.4% (n = 11) | - |
Caesarean section | 42.2% (n = 35) | 30.1% (n = 25) | 32.9% (n = 27) | - |
Neonatal Outcomes | ||||
Birth weight (g) | 3289 ± 503 | 3150 ± 497 | 3228 ± 511 | 0.140 |
Birth weight centile | 61 ± 28.5 | 52.8 ± 27.1 | 53.7 ± 26.6 | 0.089 |
Large-for-gestational-age | 21.7% (n = 18) | 14.5% (n = 12) | 8.5% (n = 7) | 0.059 |
Small-for-gestational-age | 4.1% (n = 3) | 4.1% (n = 3) | 5.6% (n = 4) | 0.758 |
Gestational age at delivery (weeks) | 38.6 ± 1.2 | 38.4 ± 1.5 | 38.9 ± 1.7 | 0.008 |
Shoulder dystocia | 4.1% (n = 4) | 5.5% (n = 4) | 4.2% (n = 3) | 0.909 |
Respiratory distress | 6.8% (n = 5) | 11.0% (n = 8) | 13.9% (n = 10) | 0.389 |
Neonatal hypoglycaemia | 15.7% (n = 13) | 19.3% (n = 16) | 6.1% (n = 5) | 0.039 |
Jaundice | 21.7% (n = 18) | 18.1% (n = 15) | 14.6% (n = 12) | 0.501 |
NICU admission | 14.5% (n = 12) | 14.5% (n = 12) | 7.3% (n = 6) | 0.268 |
Birth injury | 0 | 0 | 0 | - |
Birth defect | 4.8% (n = 4) | 2.4% (n = 2) | 4.9% (n = 4) | 0.645 |
Neonatal death | 0 | 0 | 1.2% (n = 1) | - |
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McGrath, R.T.; Glastras, S.J.; Scott, E.S.; Hocking, S.L.; Fulcher, G.R. Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study. J. Clin. Med. 2018, 7, 50. https://doi.org/10.3390/jcm7030050
McGrath RT, Glastras SJ, Scott ES, Hocking SL, Fulcher GR. Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study. Journal of Clinical Medicine. 2018; 7(3):50. https://doi.org/10.3390/jcm7030050
Chicago/Turabian StyleMcGrath, Rachel T., Sarah J. Glastras, Emma S. Scott, Samantha L. Hocking, and Gregory R. Fulcher. 2018. "Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study" Journal of Clinical Medicine 7, no. 3: 50. https://doi.org/10.3390/jcm7030050