Interventions of pregnancies with borderline gestational glucose intolerance: a randomized controlled trial / 中华全科医师杂志

ABSTRACT

Objective To explore the effectiveness of dietary treatment in reducing macrosomia risks for pregnancies with borderline gestational glucose intolerance (BGGI).Methods From July 2009 to June 2011,a total of 1046 pregnant women with BGGI were randomized into group A (intervention,n =525) and group B (non-intervention,n =521).Another 521 pregnancies with normal glucose screening were assigned into group C (normal control).Randomization was applied following stratification according to age,body mass index (BMI),prior Cesarean section (C-section) and multiparity,etc.Women in group A underwent the examinations of fasting plasma glucose (FPG),2 h-post prandial glucose and HbA1c once every 2 weeks.Their newborn outcomes were collected for analysis.Results Women of three groups were similar in age,parity,initial BMI and initial FPG.Dietary treatment for group A improved glucose-related indices and women's pregnancy weight gain (P ＜0.0l).Also,in comparison with group B,the intervention of group A reduced risk of macrosomia (9.14％ vs.13.82％,P =0.02),prior C-section rate (43.87％ vs.56.07％,P ＜ 0.01) and postpartum hemorrhage (3.81％ vs.7.10％,P =0.02).However these indices were no better than group C.Dietary treatment did not increase the risk of fetal growth restriction,neonatal hypoglycemia and hyperbilirubinemia.Conclusion As a simple noninvasive therapeutic measure for improved glucose tolerance,BGGI may reduce the risk of risk of macrosomia and prior C-section rate.