How do different strategies for diagnosing gestational diabetes affect maternal and infant outcomes?

Abstract BackgroundPostpartum depression (PPD) negatively affects the health of new mothers and can impair infant development. Both labor pain and gestational diabetes mellitus (GDM) are potential risk factors for PPD. However, the effects of epidural labor analgesia in parturients with GDM on PPD and maternal and infant outcomes have not been characterized.MethodsParturients with GDM in our hospital were assigned to the epidural group (n = 133) and no epidural (control) group (n = 130) according to their choice to receive epidural labor analgesia. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate maternal mental status at 24 h and 42 days postpartum. Data for relative variables in the perinatal period were collected, and the potential associations of epidural analgesia with PPD and maternal and infant outcomes were analyzed by univariate analysis and multivariate logistic regression analyses.ResultsEpidural analgesia was a protective factor for PPD at 24 h postpartum (odds ratio [OR], 0.301, 95% confidence interval [CI]: 0.104–0.867, p < 0.05), and the EPDS score at 24 h post-delivery showed significant correlation with that at 42 days post-delivery (Pearson correlation coefficient = 0.527, p < 0.001). The rate of neonatal admission to the neonatal intensive care unit (NICU) for hypoglycemia was higher in the epidural group (6.92%) than in the control group (1.50%; p < 0.05). Epidural analgesia and drug-based diabetes control were independent predictors of the rate of neonate transfer to the NICU for hypoglycemia.ConclusionEpidural analgesia was a protective factor for PPD at 24 h postpartum, but associated with an increased risk of neonatal transfer to the NICU for hypoglycemia. Thus, monitoring of neonatal blood glucose levels after administration of epidural analgesia in parturients with GDM may be beneficial.Clinical Trial Registrationthe study was registered in the China Clinical Registration Center (URL: http://www.chictr.org.cn/listbycreater.aspx, Registration No. ChiCTR-OOC-17013164)

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Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes

10.1002/14651858.cd010211.pub2 ◽

2013 ◽

Cited By ~ 11

Author(s):

Joanna Tieu ◽

Emily Bain ◽

Philippa Middleton ◽

Caroline A Crowther

Keyword(s):

Gestational Diabetes ◽

Infant Outcomes ◽

Interconception Care ◽

History Of ◽

Maternal And Infant Outcomes

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Low-Carbohydrate Diets for Gestational Diabetes

Nutrients ◽

10.3390/nu11081737 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1737 ◽

Cited By ~ 6

Author(s):

Sarah S. Farabi ◽

Teri L. Hernandez

Keyword(s):

Gestational Diabetes ◽

Nutrition Therapy ◽

Short Term ◽

Infant Outcomes ◽

Randomized Controlled ◽

Low Carbohydrate ◽

The Impact ◽

Maternal And Infant Outcomes ◽

Maternal Glucose

Nutrition therapy provides the foundation for treatment of gestational diabetes (GDM), and has historically been based on restricting carbohydrate (CHO) intake. In this paper, randomized controlled trials (RCTs) are reviewed to assess the effects of both low- and higher CHO nutrition approaches in GDM. The prevailing pattern across the evidence underscores that although CHO restriction improves glycemia at least in the short-term, similar outcomes could be achievable using less restrictive approaches that may not exacerbate IR. The quality of existing studies is limited, in part due to dietary non-adherence and confounding effects of treatment with insulin or oral medication. Recent evidence suggests that modified nutritional manipulation in GDM from usual intake, including but not limited to CHO restriction, improves maternal glucose and lowers infant birthweight. This creates a platform for future studies to further clarify the impact of multiple nutritional patterns in GDM on both maternal and infant outcomes.

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