Something to think about #7

A quote from A Guide to Effective Care in Pregnancy and Childbirth by Enkin, Keirse, Renfrew, and Neilson on the topic of gestational diabetes and macrosomia (big baby syndrome):

“Clinical judgement based on assessment of prepregnant weight, weight gain, and a pregnancy past 42 weeks, without any reference to glucose tolerance, is more predictive of fetal macrosomia than is the glucose tolerance test… Trials comparing the use of insulin plus diet with diet alone show a decrease in macrosomia, but no significant effect on other outcomes such as use of cesarean section, the incidence of shoulder dystocia, or perinatal mortality… One trail actually assessed the use of elective cesarean section for ‘gestational diabetes’. The result was a statistically significant increase in maternal morbidity, with no benefit shown for the baby. In one trial, no significant differences were found in maternal or neonatal outcome by use of elective early induction of labor… At least 5-70 per cent of the time this test (the glucose tolerance test) is not reproducible… As no clear improvement in perinatal mortality has been demonstrated with insulin treatment for gestational diabetes, screening of the pregnant population with glucose tolerance testing is unlikely to make a significant impact on perinatal mortality or morbidity… but the majority of macrosomic infants will be born to mothers with a normal glucose tolerance test.”

Enough said.

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  1. Naomi for President? ;)

    Since you have such a prominent blog on the subject of healthy pregnancies/healthy childbirths, have you considered posting the plethera of data out there regarding the myths behind the GBS tests and their results? Definitely eye opening to those that aren’t aware of the information!

  2. Thanks for your vote Sandra! LOL. Actually I do have two posts relating to GBS, you can find them by searching for GBS in the “search blog” box at the top of the page. Are they what you are looking for? Otherwise, let me know and I’ll see what I can conjure up ;0)

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