Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Women with gestational diabetes mellitus in the ACHOIS trial: risk factors . The Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) showed that treatment of pregnant women with mild gestational. diabetes mellitus – evaluation from the ACHOIS randomised trial Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial.

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Achoia publisher’s final edited version of this article is available at N Engl J Med. N Engl J Med. Increased birth weight and neonatal fat mass may have long-term health implications for the offspring of mothers with gestational diabetes mellitus, including an increased risk of impaired glucose tolerance and childhood obesity. Cord blood was collected and forwarded to a central laboratory for determination of the C-peptide level.

Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.

The majority of outcomes included in the achoiis outcome of the ACHOIS trial were stud of shoulder dystocia, which is considered by many to be an intermediate health outcome. These findings complement the ongoing analysis of the HAPO study data, which is focused on developing an international consensus for the diagnosis and treatment of carbohydrate intolerance during pregnancy.

The extent to which a reduction in fetal size and in the frequency of large-for-gestational-age infants as a result of treatment may have contributed to the lower rate of cesarean deliveries is unknown.

We conducted a randomized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications. There were no significant differences in afhois variables or results of the oral glucose-tolerance test between the women in the treatment group and those in the control group. Composite end point — no.


Address reprint requests to Dr. Table 4 Maternal Outcomes. Jovanovic L, Pettitt DJ. The average time from the performance of the oral glucose-tolerance test to randomization was 4. Table 3 Secondary Neonatal Outcomes.

Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.

All the women who pa rticipated in the study provided written informed consent. Anthropometric estimation of body composition. Andrews; Brown University — D. Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman’s health-related quality of life. Blackwell; Northwestern University — P.

A prospective evaluation of fetal stury screening to reduce the incidence of antepartum fetal death.

After an overnight fast, eligible women completed a blinded 3-hour g oral glucose-tolerance test. Childhood obesity and metabolic imprinting: Both the body-mass index at delivery and weight gain from enrollment to delivery were lower among women in the treatment group than among those in the control group Table 4. Comment in N Engl J Med. Women who were in the 24th to 31st week of gestation and who met the criteria for mild gestational diabetes mellitus i. Fetal and neonatal physiology.

There were no perinatal deaths. We randomly assigned women between 24 and 34 weeks’ gestation who had gestational diabetes to receive dietary advice, blood glucose monitoring, and insulin therapy as needed the intervention group or routine care.

A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes

The mean birth weight and neonatal fat mass, as well as the frequency of large-for-gestational age infants and of infants with a birth weight of g or greater, were significantly reduced in the treatment group as compared with the control group. Duration of gestation randomization — wk. Samples were analyzed at a central laboratory, and results were forwarded to the data coordinating center.


Criteria for the oral glucose tolerance test in pregnancy.

The frequency of intravenous glucose administration in the newborn did not differ significantly between groups. Although treatment of mild gestational diabetes mellitus did not significantly reduce the frequency of a composite outcome that included stillbirth or perinatal death and several neonatal complications, it did reduce the risks of fetal overgrowth, shoulder dystocia, cesarean delivery, and hypertensive disorders.

Diagnosis and classification of diabetes mellitus. A total of of these women were enrolled; women with mild gestational diabetes mellitus were assigned to the study treatment, and women with mild gestational diabetes mellitus were assigned to receive usual prenatal care.

Open in a separate window. Our composite primary outcome included perinatal mortality stillbirth or neonatal death and complications that have been linked to maternal carbohydrate intolerance: In addition, we used a g diagnostic oral glucose-tolerance test, whereas a g oral glucose-tolerance test was used in the ACHOIS trial. We thank Lisa Mele, Sc. Support Center Support Center. A value greater than the 95th percentile for any given point after birth was considered to be an elevated level.

Table 1 Characteristics of the Study Population. The diagnosis of gestational diabetes mellitus, or the knowledge that it is present, has been reported to be associated with an increase in several adverse maternal outcomes.

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