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High Blood Sugar Tied to Pregnancy Complications
Even non-diabetic levels may cause problems, study finds
By Serena Gordon
HealthDay Reporter
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WEDNESDAY, May 7 (HealthDay News) -- Women with high blood sugar levels during pregnancy face an increased risk of complications, even if the high blood sugar readings don't meet the criteria for gestational diabetes.
In a large, international study, researchers found that for each standard deviation increase in blood sugar, there was a greater risk of complications, such as having a large birth weight baby or needing a Caesarean section delivery.
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"We found strong independent associations between a mother's blood sugar levels during an oral glucose tolerance test and 28 weeks of gestation and the pregnancy outcomes," said the study's lead author, Dr. Boyd Metzger, the Tom D. Spies professor of metabolism and nutrition at the Feinberg School of Medicine at Northwestern University in Chicago.
What this means for pregnant women right now, however, isn't clear.
"Because the relationship between the mother's blood glucose level and risk tend to be continuous and linear, it is not clear where the risk reaches the point where treatment should optimally begin," said Metzger.
"We were hoping there would be a breakpoint," explained another of the study's authors, Dr. Don Coustan, professor and chair of obstetrics and gynecology at the Warren Alpert Medical School of Brown University in Providence, R.I. "But, the relationship between glucose levels and outcomes were continuous, which means it will be difficult to decide where to put the 'treating' point."
Coustan added that there will be a conference in June where pregnancy and diabetes experts will likely debate the pros and cons of treating hyperglycemia. For now, he said, he suspects that "doctors will still use the glucose threshold they're currently using."
One thing that was clear from the study is that higher odds of complications, like an increased risk of C-section or a large baby, are related to high blood sugar and not to other conditions, such as obesity or older maternal age, according to Metzger.
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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 5/7/2008
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SOURCES: Boyd Metzger, M.D., Tom D. Spies Professor of Metabolism and Nutrition, Feinberg School of Medicine, Northwestern University, Chicago; Don Coustan, M.D., professor and chair, department of obstetrics/gynecology, Warren Alpert Medical School of Brown University, and chief of obstetrics and gynecology, Women & Infants Hospital of Rhode Island, Providence; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, and professor of clinical medicine, Albert Einstein College of Medicine, New York City; May 8, 2008, New England Journal of Medicine
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