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Diabetes in Pregnancy > Drug Therapy Author: Elisha L. Brownfield, MD
Editorial changes - 2012-01-03
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Rationale:

  • There is an association between elevated maternal glucose or glycohemoglobin levels and high rates of pregnancy loss, major congenital malformations, and fetal macrosomia.
  • Reducing glycosolated hemoglobin levels may decrease complications.

Evidence:

  • In a systematic review of cohort studies, major fetal malformations were associated with elevated glycohemoglobin levels in early pregnancy on a dose-response curve. The total proportion of infants with malformation from the pooled data were 2.2% in mothers with moderately elevated glycohemoglobin levels, 8.6% in mothers with high glycohemoglobin levels, and 26.6% in mothers with the highest glycohemoglobin levels. (13).
  • In a systematic review of the literature, 17% to 29% of infants born to women with untreated gestational diabetes weighed >4,000 g at birth compared with 10% of infants born to women in the general population (24).
  • In a systematic review, the risks of major congenital malformations and fetal macrosomia were inversely related to glycemic control (38).

Comments:

  • None.
FAQs
Elisha L. Brownfield, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Justin B. Moore, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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