Impact of tighter glycaemic targets on pregnancy outcomes in a multi-ethnic cohort with gestational diabetes: A retrospective, single centre observational study

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Aims: To determine the impact of tighter glycaemic targets for gestational diabetes. Methods: Retrospective data analysis before and after introducing tighter glucose targets. Results: In 2265 pregnancies there was no change in large-for-gestational age babies (Odds ratio (OR) 1.1; 95% Confidence interval (CI) 0.8-1.6) and macrosomia (OR 1.0; 95% CI 0.6-1.7) following tighter glucose targets. Gestational hypertension (OR 0.4; 95% CI 0.2-0.7), spontaneous vaginal birth (OR 0.6; 95% CI 0.4-0.9) reduced and pharmacological treatment increased (OR 2.2; 95% CI 1.7-2.8).Composite adverse neonatal outcome (perinatal death, shoulder dystocia, fracture, nerve palsy) (OR 0.6; CI 0.02-14.2 p = 0.76)), Apgar<7 at 5 min, neonatal hypoglycaemia, respiratory distress syndrome or neonatal unit admission did not change but neonatal jaundice was reduced (OR 0.4; 95% CI 0.2-0.8). Conclusions: Tighter glycaemic targets had no impact on large-for-gestational age babies or composite adverse neonatal outcomes. There was reduced spontaneous vaginal birth, gestational hypertension, neonatal jaundice and increased pharmacological treatment.

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