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Use of a clinical‐laboratory score to guide treatment of gestational diabetes
Author(s) -
Valle Juliana B.,
Silva Jean C.,
Oliveira Daniela S.,
Martins Lisiane,
Lewandowski Amanda,
Horst Wagner
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12326
Subject(s) - medicine , gestational diabetes , apgar score , odds ratio , confounding , logistic regression , confidence interval , neonatal intensive care unit , gestational age , diabetes mellitus , birth weight , obstetrics , retrospective cohort study , multivariate analysis , pregnancy , gestation , pediatrics , endocrinology , genetics , biology
Objective To assess the outcomes of implementing a clinical‐laboratory score in the treatment of pregnant women with gestational diabetes. Methods A retrospective before‐and‐after implementation analysis was undertaken using data and neonatal outcomes for pregnant women with gestational diabetes treated before (January 2011–December 2012; control group) and after (January 2013–December 2014; score group) introduction of a newly developed score. To evaluate the effects of score adoption, odds ratios with 95% confidence intervals were calculated after adjustment for confounding factors. Results The control group included a greater proportion of women treated with diet alone (170/312 [54.5%]) than the study group did (122/391 [31.2%]; P< 0.001). By contrast, more women in the study group received metformin (172 [44.0%] vs 77 [24.7%]; P< 0.001). The neonatal outcomes, including low Apgar scores at 1 minute and at 5 minutes and neonatal intensive care unit admission, were similar in both groups. Multivariate logistic regression analysis showed that the adoption of the score did not significantly affect the choice of treatment or the birth weight rating. Conclusion The score served well as an orientation tool in therapeutic decision making and had no negative effect on the treatment choice and perinatal outcomes.