Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/138340
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Simmons, D. | - |
dc.contributor.author | Immanuel, J. | - |
dc.contributor.author | Hague, W.M. | - |
dc.contributor.author | Teede, H. | - |
dc.contributor.author | Nolan, C.J. | - |
dc.contributor.author | Peek, M.J. | - |
dc.contributor.author | Flack, J.R. | - |
dc.contributor.author | McLean, M. | - |
dc.contributor.author | Wong, V. | - |
dc.contributor.author | Hibbert, E. | - |
dc.contributor.author | Kautzky-Willer, A. | - |
dc.contributor.author | Harreiter, J. | - |
dc.contributor.author | Backman, H. | - |
dc.contributor.author | Gianatti, E. | - |
dc.contributor.author | Sweeting, A. | - |
dc.contributor.author | Mohan, V. | - |
dc.contributor.author | Enticott, J. | - |
dc.contributor.author | Cheung, N.W. | - |
dc.contributor.author | TOBOGM Research Group, | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | New England Journal of Medicine, 2023; 388(23):2132-2144 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.issn | 1533-4406 | - |
dc.identifier.uri | https://hdl.handle.net/2440/138340 | - |
dc.description | Published May 5, 2023 | - |
dc.description.abstract | BACKGROUND: Whether treatment of gestational diabetes before 20 weeks' gestation improves maternal and infant health is unclear. METHODS: We randomly assigned, in a 1:1 ratio, women between 4 weeks' and 19 weeks 6 days' gestation who had a risk factor for hyperglycemia and a diagnosis of gestational diabetes (World Health Organization 2013 criteria) to receive immediate treatment for gestational diabetes or deferred or no treatment, depending on the results of a repeat oral glucose-tolerance test [OGTT] at 24 to 28 weeks' gestation (control). The trial included three primary outcomes: a composite of adverse neonatal outcomes (birth at <37 weeks' gestation, birth trauma, birth weight of ≥4500 g, respiratory distress, phototherapy, stillbirth or neonatal death, or shoulder dystocia), pregnancy-related hypertension (preeclampsia, eclampsia, or gestational hypertension), and neonatal lean body mass. RESULTS: A total of 802 women underwent randomization; 406 were assigned to the immediate-treatment group and 396 to the control group; follow-up data were available for 793 women (98.9%). An initial OGTT was performed at a mean (±SD) gestation of 15.6±2.5 weeks. An adverse neonatal outcome event occurred in 94 of 378 women (24.9%) in the immediate-treatment group and in 113 of 370 women (30.5%) in the control group (adjusted risk difference, -5.6 percentage points; 95% confidence interval [CI], -10.1 to -1.2). Pregnancy-related hypertension occurred in 40 of 378 women (10.6%) in the immediate-treatment group and in 37 of 372 women (9.9%) in the control group (adjusted risk difference, 0.7 percentage points; 95% CI, -1.6 to 2.9). The mean neonatal lean body mass was 2.86 g in the immediate-treatment group and 2.91 g in the control group (adjusted mean difference, -0.04 g; 95% CI, -0.09 to 0.02). No between-group differences were observed with respect to serious adverse events associated with screening and treatment. CONCLUSIONS: Immediate treatment of gestational diabetes before 20 weeks' gestation led to a modestly lower incidence of a composite of adverse neonatal outcomes than no immediate treatment; no material differences were observed for pregnancy-related hypertension or neonatal lean body mass. (Funded by the National Health and Medical Research Council and others; TOBOGM Australian New Zealand Clinical Trials Registry number, ACTRN12616000924459.). | - |
dc.description.statementofresponsibility | David Simmons, Jincy Immanuel, William M Hague, Helena Teede, Christopher J Nolan, Michael J Peek, Jeff R Flack, Mark McLean, Vincent Wong, Emily Hibbert, Alexandra Kautzky-Willer, Jürgen Harreiter, Helena Backman, Emily Gianatti, Arianne Sweeting, Viswanathan Mohan, Joanne Enticott, N Wah Cheung, TOBOGM Research Group | - |
dc.language.iso | en | - |
dc.publisher | Massachusetts Medical Society | - |
dc.rights | © 2023 Massachusetts Medical Society. All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1056/nejmoa2214956 | - |
dc.subject | TOBOGM Research Group | - |
dc.subject | Humans | - |
dc.subject | Diabetes, Gestational | - |
dc.subject | Pre-Eclampsia | - |
dc.subject | Hypertension | - |
dc.subject | Pregnancy Outcome | - |
dc.subject | Pregnancy | - |
dc.subject | Pregnancy Trimester, First | - |
dc.subject | Infant, Newborn | - |
dc.subject | Australia | - |
dc.subject | Female | - |
dc.subject | Stillbirth | - |
dc.title | Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1056/NEJMoa2214956 | - |
dc.relation.grant | http://purl.org/au-research/grants/nhmrc/1104231 | - |
dc.relation.grant | http://purl.org/au-research/grants/nhmrc/2009326 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Hague, W.M. [0000-0002-5355-2955] | - |
Appears in Collections: | Obstetrics and Gynaecology publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.