";s:4:"text";s:4119:" So we do not have evidence from meta-analyses of randomized controlled trials (the highest level of scientific evidence) that treating someone with GDM lowers their risk of experiencing stillbirth or infant death.This other recent study also looked at whether treatment for GDM improves the health of the mother and baby. 2018). They found that inducing labor at 38 or 39 weeks for GDM is linked to a lower rate of Cesareans, less pre-eclampsia/hypertension, and more epidural use compared to expectant management at those times (Melamed et al. They did not find a significant difference in the risk of pre-eclampsia, Cesarean, newborn intensive care, newborn low blood sugar, preterm birth, low Apgar scores, use of forceps/vacuum, or labor induction. Practice bulletin 137: Gestational diabetes mellitus. 2017).In Canada, the current recommendation is that pregnant people with GDM should be offered an induction between 38 to 40 weeks, depending on their blood sugar control and other risk factors (Berger et al. 2016). The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. They found that elective induction with GDM is indeed linked to a higher Cesarean rate compared to elective induction with term PROM (17% versus 11%). In the U.S., birth certificates do not accurately track labor induction. Breastfeeding Medicine. The background information in the In the Evidence Based Birth® Signature Article on Diagnosing GDM, we discuss the “Hyperglycemia and Adverse Pregnancy Outcomes” (HAPO) study in detail. This data came from the Cochrane review and meta-analysis by Brown et al.
The We wanted to briefly mention two other studies that have been published since 2010. At 40 weeks, the absolute risk for those who gave birth was 10 deaths per 10,000 who gave birth versus 17 deaths per 10,000 for those who followed expectant management for one more week. There was a small amount of crossover between groups, when people didn’t stick with their random group assignments: 11% of people assigned to early term induction were not induced as intended and 9% of people assigned to expectant management actually received an early elective induction.