Back to Journals » International Journal of Women's Health » Volume 8

Hyperglycemia in pregnancy: prevalence, impact, and management challenges

Authors Farrar D

Received 20 July 2016

Accepted for publication 23 August 2016

Published 20 September 2016 Volume 2016:8 Pages 519—527

DOI https://doi.org/10.2147/IJWH.S102117

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Leyla Bahar

Peer reviewer comments 3

Editor who approved publication: Professor Elie Al-Chaer


Diane Farrar

Bradford Institute for Health Research, Maternal and Child Health, Bradford, UK

Abstract: Gestational diabetes mellitus (GDM) is one of the most common medical conditions in pregnancy, and the prevalence is growing with increasing rates of women of advanced age becoming pregnant and the increasing prevalence of maternal obesity and inactivity. GDM is associated with an increased risk of maternal and infant short- and long-term ill-health. There is a positive linear association between increasing maternal glucose at oral glucose tolerance testing and risk of important perinatal outcomes, including cesarean section, large for gestational age, and infant adiposity. A “step-up” approach, where diet and lifestyle information is provided followed by pharmacological interventions as required to control and reduce hyperglycemia, is effective at reducing the risk of macrosomia, but treatment of GDM will increase demand on health services. There is limited evidence to suggest which identification strategy is best or what thresholds should be used to diagnose GDM or what the effects of different diagnostic strategies have on short- or long-term maternal and offspring outcomes. Trials of interventions in pregnancy aimed at preventing GDM have not demonstrated a benefit; therefore, trials are needed to evaluate interventions aimed at optimizing the health of all women of childbearing age, outside of pregnancy. A consistent, evidence-based, sustained approach to supporting women to live healthily, including the achievement of a normal body mass index before and after pregnancy, is urgently needed.

Keywords: gestational diabetes, adverse perinatal outcomes, screening, glucose threshold criteria

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]