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Towards national comprehensive gestational diabetes screening-consequences for neonatal outcome and care |
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| Author: | Koivunen, Sanna1,2; Torkki, Annukka1,2; Bloigu, Aini2; |
| Organizations: |
1Department of Obstetrics and Gynecology and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland 2Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland 3Information Department, National Institute for Health and Welfare, Helsinki, Finland
4Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
5Children’s Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland |
| Format: | article |
| Version: | accepted version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 0.7 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe2019111237682 |
| Language: | English |
| Published: |
John Wiley & Sons,
2017
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| Publish Date: | 2019-11-12 |
| Description: |
AbstractIntroduction: The change from risk‐factor‐based to nearly comprehensive screening of gestational diabetes (GDM) identifies more but milder cases of the disease. The main aim of this study was to evaluate the effect of this screening policy change on neonatal outcomes and care. Material and methods: A population‐based register study in Finland. GDM cases during risk‐factor‐based (year 2006, n = 5179) and comprehensive (2010, n = 6679) screenings were identified through the Medical Birth Register. All singletons without maternal GDM or prepregnancy diabetes served as controls (n = 51 746 and n = 52 386, respectively). The main outcomes were macrosomia, neonatal hypoglycemia and the need for care in a neonatal ward. Results: In the GDM group, the mean birthweight decreased between the study years from 3660 g to 3595 g and the prevalence of macrosomia from 5.6 to 4.1% even after adjustment for maternal age, parity and prepregnancy body mass index. The adjusted mean difference in birthweight between GDM and control newborns decreased from 70 to 22 g between the study years. The prevalence of neonatal hypoglycemia increased from 18.0 to 22.1% in the GDM group. However, neonatal hypoglycemia was more often treated without care in a neonatal ward. The proportion of infants treated on a neonatal ward decreased in both the GDM and control groups between the study years. >Conclusions: In newborns, comprehensive GDM screening led to decreased mean birthweight and macrosomia rates, but the prevalence of neonatal hypoglycemia increased. This places substantial demands for delivery hospitals and healthcare resources. see all
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| Series: |
Acta obstetricia et gynecologica Scandinavica |
| ISSN: | 0001-6349 |
| ISSN-E: | 1600-0412 |
| ISSN-L: | 0001-6349 |
| Volume: | 96 |
| Issue: | 1 |
| Pages: | 106 - 113 |
| DOI: | 10.1111/aogs.13030 |
| OADOI: | https://oadoi.org/10.1111/aogs.13030 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3123 Gynaecology and paediatrics |
| Subjects: | |
| Funding: |
The study was supported by grants from the Academy of Finland, Emil Aaltonen Foundation, the Foundation of Cardiovascular Research, the Foundation of Pediatric Research, the National Graduate School of Clinical Investigation, the Novo Nordisk Foundation, Pohjois‐Suomen Terveydenhuollon tukisäätiö, Signe and Ane Gyllenberg Foundation, and the Sigrid Juselius Foundation, Yrjö Jahnsson Foundation. |
| Copyright information: |
© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.This is the peer reviewed version of the following article: Koivunen, S, Torkki, A, Bloigu, A, Gissler, M, Pouta, A, Kajantie, E, et al. Towards national comprehensive gestational diabetes screening – consequences for neonatal outcome and care. Acta Obstet Gynecol Scand 2017; 96: 106–113, which has been published in final form at https://doi.org/10.1111/aogs.13030. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |