Barclay AW, Flood VM, Brand-Miller JC, Mitchell P. Validity of carbohydrate, glycaemic index and glycaemic load data obtained using a semi-quantitative food-frequency questionnaire. Public Health Nutr.. 2008; 11:(06)573-80

Bas-lando M, Srebnik N, Farkash R, Ioscovich A, Samueloff A, Grisaru-Granovsky S. Elective induction of labor in women with gestational diabetes mellitus: an intervention that modifies the risk of cesarean section. Arch Gynecol Obstet. 2014; 290:(5)905-12

Benhalima K, Mathieu C, Damm P A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG). Diabetologia. 2015; 58:(7)1422-9

Brown AM, Rajeswari D, Bowles A. Choice of planned place of birth for women with diet-controlled gestational diabetes mellitus. Br J Midwifery. 2016; 24:(10)702-10

Carolan M, Gill GK, Steele C. Women's experiences of factors that facilitate or inhibit gestational diabetes self-management. BMC Pregnancy Childbirth. 2012; 12:(1)

Carolan M. Women's experiences of gestational diabetes self-management: A qualitative study. Midwifery. 2013; 29:(6)637-45

Cheung W. The management of gestational diabetes. Vasc Health Risk Manag.. 2009; 5:(1)153-64

Cosson E, Benchimol M, Carbillon L Universal rather than selective screening for gestational diabetes mellitus may improve fetal outcomes. Diabetes Metab.. 2006; 32:(2)140-6

Craig CL, Marshall AL, Sjöström M International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc.. 2003; 35:(8)1381-95

Erjavec K, Poljicanin T, Matijevic R. Impact of Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-based Study. Journal of Pregnancy. 2016;

Farrar D, Simmonds M, Bryant M Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts. PLoS One. 2017; 12:(4)

Feghali MN, Caritis SN, Catov JM, Scifres CM. Timing of delivery and pregnancy outcomes in women with gestational diabetes. Am J Obstet Gynecol.. 2016; 215:(2)

Figueroa Gray M, Hsu C, Kiel L, Dublin S. “It's a very big burden on me”: women's experiences using insulin for gestational diabetes. Matern Child Health J.. 2017; 21:(8)1678-85

Grabowska K, Stapińska-Syniec A, Saletra A, Jarmużek P, Bomba-Opoń D. Labour in women with gestational diabetes mellitus. Ginekol Pol.. 2017; 88:(2)81-6

Metzger BE, Lowe LP Hyperglycaemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358:1999-2002

Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012; 35:(7)1492-8

Hui AL, Sevenhuysen G, Harvey D, Salamon E. Food choice decision-making by women with gestational diabetes. Can J Diabetes. 2014; 38:(1)26-31

Kennedy J. Diagnosis and screening of gestational diabetes: conflicts of policy. MIDIRS Midwifery Digest. 2017; 27

Lawrence JM. Women with diabetes in pregnancy: different perceptions and expectations. Best Pract Res Clin Obstet Gynaecol.. 2011; 25:(1)15-24

Lindsay RS, Mackin ST, Nelson SM. Gestational diabetes mellitus—right person, right treatment, right time?. BMC Med. 2017; 15:(1)

Louie JCY, Markovic TP, Perera N A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care. 2011; 34:(11)2341-6

Madazlı R, Tuten A, Calay Z, Uzun H, Uludag S, Ocak V. The incidence of placental abnormalities, maternal and cord plasma malondialdehyde and vascular endothelial growth factor levels in women with gestational diabetes mellitus and nondiabetic controls. Gynecol Obstet Invest. 2008; 65:(4)227-32

McCance DR. Pregnancy and diabetes. Best Pract Res Clin Endocrinol Metab.. 2011; 25:(6)945-58

Meek CL, Lewis HB, Patient C, Murphy HR, Simmons D. Diagnosis of gestational diabetes mellitus: falling through the net. Diabetologia. 2015; 58:(9)2003-12

Melamed N, Ray JG, Geary M Induction of labour before 40 weeks is associated with lower rat of caesarean delivery in women with gestational diabetes mellitus. Am J Obstet Gynecol.. 2016; 364:e1-e8

Murphy HR. Gestational diabetes: what's new?. Medicine. 2010; 38:(12)676-8

Diabetes in Pregnancy: management of diabetes and its complications from preconception to the postnatal period [CG63].London: NICE; 2008

Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period [NG3].London: NICE; 2015

Niu B, Lee VR, Cheng YW, Frias AE, Nicholson JM, Caughey AB. What is the optimal gestational age for women with gestational diabetes type A1 to deliver?. Am J Obstet Gynecol.. 2014; 211:(4)418.e1-418.e6

Nolan JA, McCrone S, Chertok IRA. The maternal experience of having diabetes in pregnancy. J Am Acad Nurse Pract.. 2011; 23:(11)611-18

Parsons J, Ismail K, Amiel S, Forbes A. Perceptions among women with gestational diabetes. Qual Health Res.. 2014; 24:(4)575-85

Persson M, Hörnsten Å, Winkvist A, Mogren I. “Mission Impossible”? Midwives' experiences counseling pregnant women with gestational diabetes mellitus. Patient Educ Couns.. 2011; 84:(1)78-83

Poolsup N, Suksomboon N, Amin M. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One. 2014; 9:(3)

Poston L, Bell R, Croker H Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol.. 2015; 3:(10)767-77

Rogers K, Hughes C. Recognising the risks: the midwife's role in identifying women at risk of gestational diabetes. MIDIRS Midwifery Digest. 2010; 20

Sathyapalan T, Mellor D, Atkin SL. Obesity and gestational diabetes. Semin Fetal Neonatal Med. 2010; 15:(2)89-93

Scott DA, Loveman E, McIntyre L, Waugh N. Screening for gestational diabetes: a systematic review and economic evaluation. Health Technol Assess.. 2002; 6:(11)1-161

Simmons D. Diabetes and obesity in pregnancy. Best Pract Res Clin Obstet Gynaecol.. 2011; 25:(1)25-36

Stuart A, Matthiesen LS, Källén KB. Association between 5 min Apgar scores and planned mode of delivery in diabetic pregnancies. Acta Obstet Gynecol Scand.. 2011; 90:(4)325-31

Sutton AL, Mele L, Landon MB Delivery timing and cesarean delivery risk in women with mild gestational diabetes mellitus. Am J Obstet Gynecol.. 2014; 211:(3)

Thangaratinam S, Rogozinska E, Jolly K Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012; 344:(May16 4)

Tieu J, Middleton P, McPhee AJ, Crowther CA. Screening and subsequent management for gestational diabetes for improving maternal and infant health. Cochrane Database Syst Rev.. 2010; (7)

Tieu J, McPhee AJ, Crowther CA, Middleton P, Shepherd E. Screening for geatational diabetes mellitus based on different risk profiles and settings for improving maternal and infant health. Cochrane Database Syst Rev.. 2017; 8

Walsh JM, McGowan CA, Mahony R, Foley ME, McAuliffe FM. Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial. BMJ.. 2012; 345:(aug30 1)

Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy.Geneva: WHO; 2013

Yogev Y, Metzger BE, Hod M. Establishing diagnosis of gestational diabetes mellitus: impact of the hyperglycemia and adverse pregnancy outcome study. Semin Fetal Neonatal Med. 2009; 14:(2)94-100

Zhang C, Tobias DK, Chavarro JE Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study. BMJ. 2014; 349

Managing gestational diabetes mellitus: Audit data of outcomes for women and neonates

02 December 2018
Volume 26 · Issue 12



Literature on the management of gestational diabetes mellitus (GDM) and other pre-existing diabetic conditions in pregnancy suggest treatments that may ameliorate outcomes for both mother and neonates.


To examine the effects of GDM on outcomes for mothers and neonates and the effects of maternal age, body mass index and gestational age at birth with or without induction of labour for women with GDM.


Audit data of outcomes for GDM groups were analysed against outcomes for the general population of women giving birth in this unit. Descriptive statistics organised the data and inferential statistics determined the significant differences between frequencies.


Most of the results were predictive when comparing women with and without GDM for mode of birth and outcomes for mothers and neonates. This included significant differences for hospital birth, induction of labour and caesarean section.


Good glycaemic control and healthy lifestyle measures are advised to minimise development of obesity in women with GDM and diverse outcomes for both mothers and neonates.

Gestational diabetes mellitus (GDM) is defined as glucose intolerance, increased insulin resistance and usually occurring in the second trimester of pregnancy (HAPO Study Cooperative Research Group, 2008; McCance, 2011). The condition is associated with increased risks and poorer outcomes of pregnancy for both mother and neonate, which are attributed to the increased prevalence of obesity, insulin resistance and hypertension in childbearing women. The condition affects 3-5% of all pregnancies in the Caucasian population (Grabowska et al, 2017). According to Hedderson et al (2012), increased risk of GDM varies with body mass index (BMI) thresholds, and by racial/ethnic groups in Asian and south-east Asian women, who may need preventative strategies in addition to weight management interventions.

Any woman diagnosed with GDM can expect to be monitored more frequently, which may lead to interventions in pregnancy and labour. In addition, the mother's diabetes may lead to over-exposure to the hyperglycaemic conditions in utero and the health of the fetus being compromised. After birth, the neonate may display clinical complications of hypoglycaemia, hyperbilirubinaemia, polycythaemia and respiratory distress syndrome, among others (National Institute for Health and Care Excellence (NICE), 2015).

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