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https://swslhd.intersearch.com.au/swslhdjspui/handle/1/12922| Title: | Effect of treatment for early gestational diabetes mellitus on neonatal respiratory distress: A secondary analysis of the TOBOGM study |
| Authors: | Simmons, D. Immanuel, J. Hague, W. M. Coat, S. Teede, H. Nolan, C. J. Peek, M. J. Flack, J. R. McLean, M. Wong, V. W. Hibbert, E. J. Kautzky-Willer, A. Harreiter, J. Backman, H. Gianatti, E. Sweeting, A. Mohan, V. Cheung, N. W. Dalal, R. Soldatos, G. Padmanabhan, S. Rajagopal, R. Rudland, V. Kiss, H. Schwarcz, E. Anjana, R. M. Ram, U. |
| SWSLHD Author: | Flack, Jeffrey R. Wong, Vincent W. |
| Affiliates: | School of Medicine, Western Sydney University, Campbelltown, NSW, Australia Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia Department of Medicine, Monash University, Melbourne, VIC, Australia Department of Medicine, Canberra Hospital and Australian National University, Canberra, ACT, Australia School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia Department of Medicine, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia Department of Medicine, Blacktown Hospital, Sydney, NSW, Australia Department of Medicine, Liverpool Hospital and University of New South Wales, Sydney, NSW, Australia Nepean Clinical School, Faculty of Medicine and Health, University of Sydney and Nepean Hospital, Sydney, NSW, Australia Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria Department of Medicine, Landesklinikum Scheibbs, Scheibbs, Austria Department of Obstetrics and Gynecology, Faculty of Medicine and Health, �rebro University, �rebro, Sweden Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch, WA, Australia Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India Department of Medicine, Westmead Hospital, Sydney, NSW, Australia |
| Department: | Bankstown-Lidcombe Hospital, Department of Diabetes & Endocrinology Liverpool Hospital, Department of Medicine |
| Issue Date: | 2024 |
| Journal: | BJOG: An International Journal of Obstetrics and Gynaecology |
| Publisher: | John Wiley and Sons Inc |
| 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. � 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. |
| URI: | https://swslhd.intersearch.com.au/swslhdjspui/handle/1/12922 |
| ISSN: | 14700328 (ISSN) |
| Digital object identifier: | 10.1111/1471-0528.17938 |
| Appears in Collections: | Bankstown-Lidcombe Hospital Liverpool Hospital |
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