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Type: Journal article
Title: Birth outcomes in women with gestational diabetes managed by lifestyle modification alone: The PANDORA Study
Author: Cheng, E.
Longmore, D.
Barzi, F.
Barr, E.L.M.
Lee, I.
Whitbread, C.
Boyle, J.A.
Oats, J.
Connors, C.
McIntyre, H.D.
Kirkwood, M.
Dempsey, K.
Zhang, X.
Thomas, S.
Williams, D.
Zimmet, P.
Brown, A.D.H.
Shaw, J.E.
Maple-Brown, L.
PANDORA Study research team,
Citation: Diabetes Research and Clinical Practice, 2019; 157:107876-1-107876-10
Publisher: Elsevier
Issue Date: 2019
ISSN: 0168-8227
Statement of
E. Cheng, D.K. Longmore, F. Barzi, E.L.M. Barr, I.L. Lee, C. Whitbread, J.A. Boyle, J. Oats, C. Connors, H.D. McIntyre, M. Kirkwood, K. Dempsey, X. Zhang, S. Thomas, D. Williams, P. Zimmet, A.D.H. Brown, J.E. Shaw, L.J. Maple-Brown [On behalf of PANDORA Study Research Team]
Abstract: Aims: To assess outcomes of women in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) cohort with gestational diabetes mellitus (GDM) managed by lifestyle modification compared with women without hyperglycaemia in pregnancy. Methods: Indigenous (n=97) and Europid (n=113) women managed by lifestyle modification were compared to women without hyperglycaemia (n=235). Multivariate linear and logistic regressions assessed whether GDM-lifestyle women had poorer outcomes compared to women without hyperglycaemia. Results: Women with GDM-lifestyle had higher body mass index and lower gestational weight gain than women without hyperglycaemia. On univariate analysis, gestational age at delivery was lower and induction rates were higher in women with GDM-lifestyle than without hyperglycaemia. On multivariable regression, GDM-lifestyle was associated with lower gestational age at delivery (by 0.73 weeks), lower birthweight z-score (by 0.26, p=0.007), lower likelihood of large for gestational age (LGA) [OR (95% CI): 0.55 (0.28, 1.02), p=0.059], and greater likelihood of labour induction [2.34 (1.49, 3.66), p < 0.001] than women without hyperglycaemia Conclusion: Women with GDM managed by lifestyle modification had higher induction rates and their offspring had lower birthweight z-scores, with a trend to lower LGA than those without hyperglycaemia in pregnancy. Further studies are indicated to explore reasons for higher induction rates.
Keywords: Gestational diabetes mellitus; lifestyle modification; Aboriginal and Torres Strait Islander; induction of labour; hyperglycaemia in pregnancy
Rights: © 2019 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.diabres.2019.107876
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