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Effect of treatment for early gestational diabetes mellitus on neonatal respiratory distress: A secondary analysis of the TOBOGM study.
Simmons, David; Immanuel, Jincy; Hague, William M; Coat, Suzette; Teede, Helena; Nolan, Christopher J; Peek, Michael J; Flack, Jeff R; McLean, Mark; Wong, Vincent W; Hibbert, Emily J; Kautzky-Willer, Alexandra; Harreiter, Jürgen; Backman, Helena; Gianatti, Emily; Sweeting, Arianne; Mohan, Viswanathan; Cheung, N Wah.
Afiliación
  • Simmons D; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
  • Immanuel J; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
  • Hague WM; Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
  • Coat S; Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
  • Teede H; Department of Medicine, Monash University, Melbourne, Victoria, Australia.
  • Nolan CJ; Department of Medicine, Canberra Hospital and Australian National University, Canberra, Australian Capital Territory, Australia.
  • Peek MJ; School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
  • Flack JR; Department of Medicine, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.
  • McLean M; Department of Medicine, Blacktown Hospital, Sydney, New South Wales, Australia.
  • Wong VW; Department of Medicine, Liverpool Hospital and University of New South Wales, Sydney, New South Wales, Australia.
  • Hibbert EJ; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney and Nepean Hospital, Sydney, New South Wales, Australia.
  • Kautzky-Willer A; Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
  • Harreiter J; Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
  • Backman H; Department of Medicine, Landesklinikum Scheibbs, Scheibbs, Austria.
  • Gianatti E; Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Sweeting A; Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch, Western Australia, Australia.
  • Mohan V; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
  • Cheung NW; Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India.
BJOG ; 2024 Aug 19.
Article en En | MEDLINE | ID: mdl-39157877
ABSTRACT

OBJECTIVE:

To identify factors associated with neonatal respiratory distress (NRD) in early Gestational diabetes mellitus (eGDM).

DESIGN:

Nested case-control analysis of the TOBOGM trial.

SETTING:

Seventeen hospitals Australia, Sweden, Austria and India. POPULATION Pregnant women, <20 weeks' gestation, singleton, GDM risk factors.

METHODS:

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. MAIN OUTCOME

MEASURES:

NRD definition ≥4 h of respiratory support (supplemental oxygen or supported ventilation) postpartum. Respiratory distress syndrome (RDS) Supported ventilation and ≥24 h nursery stay.

RESULTS:

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.

CONCLUSIONS:

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido