Impact of tighter glycaemic targets on pregnancy outcomes in a multi-ethnic cohort with gestational diabetes: A retrospective, single centre observational study

Aims To determine the impact of tighter glycaemic targets for gestational diabetes. Methods Retrospective data analysis before and after introducing tighter glucose targets. Results In 2265 pregnancies there was no change in large-for-gestational age babies (Odds ratio (OR) 1.1; 95% Confidence interval (CI) 0.8–1.6) and macrosomia (OR 1.0; 95% CI 0.6–1.7) following tighter glucose targets. Gestational hypertension (OR 0.4; 95% CI 0.2–0.7), spontaneous vaginal birth (OR 0.6; 95% CI 0.4–0.9) reduced and pharmacological treatment increased (OR 2.2; 95% CI 1.7–2.8). Composite adverse neonatal outcome (perinatal death, shoulder dystocia, fracture, nerve palsy) (OR 0.6; CI 0.02–14.2 p = 0.76)), Apgar<7 at 5 min, neonatal hypoglycaemia, respiratory distress syndrome or neonatal unit admission did not change but neonatal jaundice was reduced (OR 0.4; 95% CI 0.2–0.8). Conclusions Tighter glycaemic targets had no impact on large-for-gestational age babies or composite adverse neonatal outcomes. There was reduced spontaneous vaginal birth, gestational hypertension, neonatal jaundice and increased pharmacological treatment.