Birth outcomes in women with gestational diabetes managed by lifestyle modification alone

The PANDORA study

On behalf of PANDORA Study research team

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Article number107876
Pages (from-to)1-10
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume157
Issue numberNovember
Early online date3 Oct 2019
DOIs
Publication statusPublished - 1 Nov 2019

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Gestational Diabetes
Life Style
Parturition
Pregnancy
Hyperglycemia
Gestational Age
Induced Labor
Pregnancy in Diabetics
Weight Gain
Linear Models
Body Mass Index
Logistic Models

Cite this

@article{1ba172d5fc1b4ee0b34ad4bf4c544518,
title = "Birth outcomes in women with gestational diabetes managed by lifestyle modification alone: The PANDORA study",
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 = "Aboriginal and Torres Strait Islander, Gestational diabetes mellitus, Hyperglycaemia in pregnancy, Induction of labour, Lifestyle modification",
author = "{On behalf of PANDORA Study research team} and E. Cheng and Longmore, {D. K.} and F. Barzi and Barr, {E. L.M.} and Lee, {I. L.} and C. Whitbread and Boyle, {J. A.} and J. Oats and C. Connors and McIntyre, {H. D.} and M. Kirkwood and K. Dempsey and X. Zhang and S. Thomas and D. Williams and P. Zimmet and Brown, {A. D.H.} and Shaw, {J. E.} and Maple-Brown, {L. J.}",
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language = "English",
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journal = "Diabetes Research and Clinical Practice",
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Birth outcomes in women with gestational diabetes managed by lifestyle modification alone : The PANDORA study. / On behalf of PANDORA Study research team.

In: Diabetes Research and Clinical Practice, Vol. 157, No. November, 107876, 01.11.2019, p. 1-10.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Birth outcomes in women with gestational diabetes managed by lifestyle modification alone

T2 - The PANDORA study

AU - On behalf of PANDORA Study research team

AU - Cheng, E.

AU - Longmore, D. K.

AU - Barzi, F.

AU - Barr, E. L.M.

AU - Lee, I. L.

AU - Whitbread, C.

AU - Boyle, J. A.

AU - Oats, J.

AU - Connors, C.

AU - McIntyre, H. D.

AU - Kirkwood, M.

AU - Dempsey, K.

AU - Zhang, X.

AU - Thomas, S.

AU - Williams, D.

AU - Zimmet, P.

AU - Brown, A. D.H.

AU - Shaw, J. E.

AU - Maple-Brown, L. J.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - 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.

AB - 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.

KW - Aboriginal and Torres Strait Islander

KW - Gestational diabetes mellitus

KW - Hyperglycaemia in pregnancy

KW - Induction of labour

KW - Lifestyle modification

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DO - 10.1016/j.diabres.2019.107876

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JF - Diabetes Research and Clinical Practice

SN - 0168-8227

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