Table 1.
Quantitative estimates of maternal and neonatal adverse pregnancy outcomes associated with gestational diabetes mellitus (GDM) stratified by the use of pharmacological interventions for the management of the disease.
| Pharmacological Management: No (A) |
Pharmacological Management: Yes (B) |
Pharmacological Management: Not Reported (C) |
|
|---|---|---|---|
| Maternal outcomes | |||
| Pre-eclampsia | 1.39 (0.99–1.96) | 1.24 (0.94–1.63) | 1.46 (1.21–1.78) * |
| Induction of labor | 1.33 (0.97–1.82) | 1.83 (0.02–136.80) | 1.88 (1.16–3.04) * |
| Instrumental delivery | 0.83 (0.02–41.94) * | 0.52 (0.20–1.33) | 1.10 (0.59–2.06) |
| Caesarean section | 1.16 (1.03–1.32) | 1.70 (0.99–2.90) | 1.38 (1.20–1.58) * |
| Shoulder dystocia | 1.26 (0.98–1.62) | 1.29 (0.87–1.92) | 1.48 (0.99–2.20) |
| Premature rupture of membranes | – | – | 1.13 (1.06–1.20) * |
| Postpartum hemorrhage | 1.07 (0.68–1.66) | – | 0.94 (0.75–1.17) |
| Neonatal outcomes | |||
| Stillbirth | 1.08 (0.38–3.11) | – | 0.78 (0.58–1.05) |
| Congenital malformation | 0.78 (0.36–1.70) | 1.62 (0.65–4.07) | 1.18 (1.10–1.26) * |
| Pre-term birth | 1.51 (1.26–1.80) * | 1.22 (0.99–1.50) | 1.51 (1.19–1.93) * |
| Respiratory distress syndrome | 1.38 (0.76–2.50) | 1.57 (1.19–2.08) * | 1.59 (0.89–2.83) |
| Low 1′ APGAR score | 1.43 (1.01–2.03) | 1.63 (0.88–3.02) | – |
| Low 5′ APGAR score | 1.11 (0.74–1.66) | 0.94 (0.70–1.27) | 1.12 (0.96–1.32) |
| Macrosomia | 1.70 (1.23–2.36) * | 1.56 (0.92–2.66) | 1.48 (1.13–1.95) |
| LGA birth | 1.57 (1.25–1.97) * | 1.61 (1.09–2.37) * | 1.42 (0.98–2.06) |
| Low birthweight | 1.40 (1.12–16.73) | 0.87 (0.53–1.43) | 0.94 (0.84–1.05) |
| SGA birth | 0.83 (0.55–1.23) | 0.77 (0.46–1.29) | 1.19 (0.67–2.11) |
| Neonatal hypoglycemia | 3.94 (0.37–42.05) | – | 11.71 (7.49–18.30) * |
| Neonatal jaundice | 1.33 (0.94–1.88) | 1.28 (1.02–1.62) * | – |
| Admission to NICU | 1.34 (0.86–2.09) | 2.29 (1.59–3.31) * | 2.28 (1.26–4.13) * |
Data are presented as odds ratio (OR) estimates, adjusted for potential confounding factors (i.e., maternal age, pre-pregnancy body mass index, gestational weight gain, gravidity, parity, smoking history, and chronic hypertension). Values in brackets indicate the 95% Confidence Interval for each OR. Pharmacological interventions refer to the use of insulin only. Column A includes studies in which GDM women had never used insulin during the course of the disease; column B includes studies in which different proportions of GDM women were treated with insulin; column B includes studies in which insulin use was not reported [2]. Asterisks (*) denote statistical significance. LGA: large for gestational age; SGA: small for gestational age; NICU: neonatal intensive care unit.