Timing of treatment initiation for mild gestational diabetes mellitus and perinatal outcomes.


OBJECTIVE:The purpose of this study was to examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes mellitus (GDM) and maternal and perinatal outcomes. STUDY DESIGN:We conducted a secondary analysis of a multicenter randomized treatment trial of mild GDM in which women with mild GDM were assigned randomly to treatment vs usual care. The primary outcome of the original trial, as well as this analysis, was a composite perinatal adverse outcome that included neonatal hypoglycemia, hyperbilirubinemia, hyperinsulinemia, and perinatal death. Other outcomes that were examined included the frequency of large for GA, birthweight, neonatal intensive care unit admission, gestational hypertension/preeclampsia, and cesarean delivery. The interaction between GA at treatment initiation (stratified as 24-26, 27, 28, 29, and ≥30 weeks of gestation) and treatment group (treated vs routine care), with the outcomes of interest, was used to determine whether GA at treatment initiation was associated with outcome differences. RESULTS:Of 958 women whose cases were analyzed, those who initiated treatment at an earlier GA did not gain an additional treatment benefit compared with those who initiated treatment at a later GA (probability value for interaction with the primary outcome, .44). Similarly, there was no evidence that other outcomes were improved significantly by earlier initiation of GDM treatment (large for GA, P = .76; neonatal intensive care unit admission, P = .8; cesarean delivery, P = .82). The only outcome that had a significant interaction between GA and treatment was gestational hypertension/preeclampsia (P = .04), although there was not a clear cut GA trend where this outcome improved with treatment. CONCLUSION:Earlier initiation of treatment of mild GDM was not associated with stronger effect of treatment on perinatal outcomes.


Am J Obstet Gynecol


Palatnik A,Mele L,Landon MB,Reddy UM,Ramin SM,Carpenter MW,Wapner RJ,Varner MW,Rouse DJ,Thorp JM Jr,Sciscione A,Catalano P,Saade GR,Caritis SN,Sorokin Y,Eunice Kennedy Shriver National Institute of Child Health and Human De




Has Abstract


2015-10-01 00:00:00














  • Vascular reactivity in men and women of reproductive age.

    abstract:OBJECTIVE:This study was undertaken to document vascular reactivity in both phases of normal menstrual cycles and anovulatory cycles of women receiving oral contraceptives and to compare vascular reactivity of women in the follicular phase of the normal menstrual cycle with that of men of a similar age group. STUDY DE...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Bowyer L,Brown MA,Jones M

    更新日期:2001-07-01 00:00:00

  • Evaluation of multiple-marker screening for Down syndrome in a statewide population.

    abstract:OBJECTIVE:Our purpose was to evaluate our experience with a statewide, multiple-marker Down syndrome screening program. STUDY DESIGN:The results of 18,712 screening tests performed from July 1, 1991, to Oct. 31, 1992, were reviewed. Amniocentesis and aneuploidy detection rates were compared with the experience of a pr...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Wenstrom KD,Williamson RA,Grant SS,Hudson JD,Getchell JP

    更新日期:1993-10-01 00:00:00

  • Hereditary thrombophilia and recurrence of ischemic placental disease.

    abstract:OBJECTIVE:We sought to evaluate whether testing for hereditary thrombophilia alone or in combination with second-trimester uterine artery Doppler (UAD) is useful in predicting recurrent complications in patients with previous preeclampsia, placental abruption, or stillbirth. STUDY DESIGN:Between 2001 and 2005, 110 con...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,多中心研究


    authors: Verspyck E,Borg JY,Roman H,Thobois B,Pia P,Marpeau L

    更新日期:2010-01-01 00:00:00

  • Experience of a controlling or threatening partner among mothers with persistent symptoms of depression.

    abstract:OBJECTIVE:We evaluated the prevalence of symptoms of maternal depression (SMD) that continue beyond the postpartum period and the association between persistent SMD and reporting a controlling or threatening partner. STUDY DESIGN:We combined data from a survey of mothers 2-6 months after delivery and its 2-year follow...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Blabey MH,Locke ER,Goldsmith YW,Perham-Hester KA

    更新日期:2009-08-01 00:00:00

  • Differential symptom response to parenteral estrogen and/or androgen administration in the surgical menopause.

    abstract::The investigation of estrogen and/or androgen administration on physical and psychological symptoms in the surgical menopause was carried out in a prospective, double-blind, crossover design. When patients who received either a combined estrogen-androgen drug or androgen alone were compared with those who received est...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 临床试验,杂志文章


    authors: Sherwin BB,Gelfand MM

    更新日期:1985-01-15 00:00:00

  • Phencyclidine use during pregnancy.

    abstract::Phencyclidine, a frequently abused drug, has been shown to cross the placenta and may cause harmful effects in the fetus. Therefore, a prospective study was undertaken to determine the extent of phencyclidine use during pregnancy. Two thousand three hundred twenty-seven pregnant women were screened for phencyclidine u...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Golden NL,Kuhnert BR,Sokol RJ,Martier S,Bagby BS

    更新日期:1984-02-01 00:00:00

  • Spectral analysis of fetal heart rate in sheep: the occurrence of respiratory sinus arrhythmia.

    abstract::Respiratory sinus arrhythmia is a pattern of rhythmic variation in the heart rate that occurs at the frequency of respiration and is mediated principally by the vagus nerve. Spectral analysis can decompose the variance of a series of sequential measures into constituent frequencies to measure and verify whether there ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Donchin Y,Caton D,Porges SW

    更新日期:1984-04-15 00:00:00

  • Pitfalls in assessing chorioamnionicity: novel observations and literature review.

    abstract::Accurate diagnosis of chorioamnionicity in multiple pregnancies is the key to appropriate clinical management of multiple gestation. Although prenatal ultrasound assessment of chorioamnionicity is well established and highly accurate if performed in early pregnancy, exceptions and artifacts arise from anatomic variati...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,评审


    authors: Lu J,Cheng YKY,Ting YH,Law KM,Leung TY

    更新日期:2018-09-01 00:00:00

  • Sonohysterography and endometrial cancer: incidence and functional viability of disseminated malignant cells.

    abstract:OBJECTIVE:The purpose of this study was to evaluate sonohysterography in patients with endometrial cancer and to determine whether (1) transtubal fluid spill occurs during routine sonohysterography, (2) a critical infusion volume for spill exists, or (3) disseminated cancer cells demonstrate viability. STUDY DESIGN:At...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Berry E,Lindheim SR,Connor JP,Hartenbach EM,Schink JC,Harter J,Eickhoff JC,Kushner DM

    更新日期:2008-09-01 00:00:00

  • Umbilical cord compression associated with amniotomy: laboratory observations.

    abstract::Impairment of umbilical cord blood flow has been associated with periodic fetal heart rate changes termed "variable decelerations." These patterns may be observed after amniotomy. A chronic fetal rhesus monkey preparation has been used to investigate this clinical observation. Loss of amniotic fluid produced variable ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Gabbe SG,Ettinger BB,Freeman RK,Martin CB

    更新日期:1976-10-01 00:00:00

  • Host reaction to vaginally inserted collagen containing polypropylene implants in sheep.

    abstract:OBJECTIVE:We aimed to characterize the effect of vaginal or abdominal mesh insertion and of different collagen augmentation of polypropylene mesh in a sheep model. Outcome measures were passive and active biomechanical properties and semiquantitative morphometry. STUDY DESIGN:Forty-two Texel sheep were used: 6 were no...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Feola A,Endo M,Urbankova I,Vlacil J,Deprest T,Bettin S,Klosterhalfen B,Deprest J

    更新日期:2015-04-01 00:00:00

  • An arm-based network meta-analysis on treatments for vulvar lichen sclerosus and a call for development of core outcome sets.

    abstract:OBJECTIVE:The purpose of the present systematic review is to evaluate the available medical treatments for vulvar lichen sclerosus, using an arm-based network meta-analysis protocol. DATA SOURCES:We searched Medline (1966-2019), Scopus (2004-2019), Cochrane Central Register of Controlled Trials CENTRAL (1999-2019), Cl...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Pergialiotis V,Bellos I,Biliou EC,Varnava P,Mitsopoulou D,Doumouchtsis SK,CHORUS, an International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health (i-chorus.org).

    更新日期:2020-06-01 00:00:00

  • Type and screen: a safe and effective preoperative blood ordering policy with emphasis on its use in obstetrics and gynecology.

    abstract::In September, 1979, the Transfusion Committee at the University of Texas Medical Branch in Galveston implemented a preoperative blood ordering policy of type and screen (TS) for selected surgical procedures. During the first year in which this policy was in force, 2,301 TS requests were received, most of them for pati...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Patten E,Alperin JB

    更新日期:1982-03-01 00:00:00

  • Transabdominal cervicoisthmic cerclage: a reappraisal 25 years after its introduction.

    abstract::Most cerclage operations for cervical insufficiency are performed transvaginally. The transabdominal route is beneficial in treating patients with cervices that are either extremely short, congenitally deformed, deeply lacerated, or markedly scarred because of previously failed transvaginal cerclage procedures. The av...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Novy MJ

    更新日期:1991-06-01 00:00:00

  • Neonatal death and morbidity in vertex-nonvertex second twins according to mode of delivery and birth weight.

    abstract:OBJECTIVE:The purpose of this study was to assess the risk of neonatal death and morbidity in vertex-nonvertex second twins according to the mode of delivery and birth weight. STUDY DESIGN:Data from a retrospective cohort study that was based on all twin births in the United States (1995-1997) were used. RESULTS:A to...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Yang Q,Wen SW,Chen Y,Krewski D,Fung Kee Fung K,Walker M

    更新日期:2005-03-01 00:00:00

  • Does the type of surgery for early-stage endometrial cancer affect the rate of reported lymphovascular space invasion in final pathology specimens?

    abstract:OBJECTIVE:Laparoscopically assisted vaginal hysterectomy (LAVH), which usually involves the use of an intrauterine manipulator for optimal surgical control, has been shown to be as effective and safe as conventional total abdominal hysterectomy (TAH) for the staging of endometrial carcinoma. The purpose of this study w...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Momeni M,Kolev V,Cardenas-Goicoechea J,Getrajdman J,Fishman D,Chuang L,Kalir T,Rahaman J,Zakashansky K

    更新日期:2013-01-01 00:00:00

  • Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance.

    abstract::We report a case of uterine cancer and invasive cervical cancer, detected incidentally during the female-to-male sex reassignment surgery. The management of these patients is presented. Such individuals may not be receiving regular gynecologic care appropriate to their remaining genital organs; symptoms of malignant d...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Urban RR,Teng NN,Kapp DS

    更新日期:2011-05-01 00:00:00

  • Effect of uterine contractility and maternal hypotension on prolonged decelerations after bupivacaine epidural anesthesia.

    abstract::Patients with prolonged decelerations after bupivacaine epidural anesthesia were matched with control patients. It was found that there were no differences in the decrease in mean arterial blood pressure after epidural anesthesia between those with prolonged decelerations (5 +/- 9 mm Hg) and those without (5 +/- 9 mm ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Steiger RM,Nageotte MP

    更新日期:1990-09-01 00:00:00

  • Serologic response to the E4, E6, and E7 proteins of human papillomavirus type 16 in pregnant women.

    abstract:OBJECTIVE:In a seroepidemiologic study the effects of pregnancy and other factors on humoral response to human papillomavirus type 16 infection were examined. STUDY DESIGN:Multiple serum samples were taken at 3-month intervals for 15 months from 77 pregnant and 85 nonpregnant women. Serologic response to human papillo...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Sethi S,Müller M,Schneider A,Blettner M,Smith E,Turek L,Wahrendorf J,Gissmann L,Chang-Claude J

    更新日期:1998-02-01 00:00:00

  • Two pregnancy-associated serum proteins with pregnancy-specific beta1-glycoprotein determinants.

    abstract::A protein showing strong antigenic cross-reactivity with the "pregnancy-specific" beta1-glycoprotein (PSbetaG) was demonstrated in serum of pregnant women during the second and third trimesters, but not in sera from normal men and nonpregnant women. The described protein had alpha2-electrophoretic mobility and its mol...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Teisner B,Westergaard JG,Folkersen J,Husby S,Svehag SE

    更新日期:1978-06-01 00:00:00

  • Immunologic infertility. I. Cervical mucus antibodies and postcoital test.

    abstract::SAA and SIA were assayed in the sera of 172 infertile couples and in the CM of the women and 18 control subjects. Complete infertility evaluation was performed in all subjects except the controls. Results of these studies were correlated with PCT's. Sperm antibodies were detected in the CM of 25.6% of infertile women ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Moghissi KS,Sacco AG,Borin K

    更新日期:1980-04-01 00:00:00

  • Mode of delivery for the morbidly obese with prior cesarean delivery: vaginal versus repeat cesarean section.

    abstract:OBJECTIVE:We sought to describe the peripartum outcome of women weighing >300 pounds (135 kg) who were candidates for trial of labor after a prior cesarean delivery. STUDY DESIGN:All pregnant women who weighed in excess of 300 pounds and had a prior cesarean delivery were included in this prospective investigation. St...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Chauhan SP,Magann EF,Carroll CS,Barrilleaux PS,Scardo JA,Martin JN Jr

    更新日期:2001-08-01 00:00:00

  • Ectopic pregnancy following treatment with human gonadotropins.

    abstract::After treatment with human gonadotropins, 289 anovulatory women with apparently normal fallopian tubes became pregnant 379 times. Ten ectopic pregnancies in nine women were diagnosed, for an incidence of 2.7% of all conceptions. All the ectopic pregnancies were found in the fallopian tubes. Four patients had also an i...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Gemzell C,Guillome J,Wang CF

    更新日期:1982-08-01 00:00:00

  • Fetal vascular responses to prostacyclin.

    abstract::Prostacyclin is a potent vasodilator produced by both maternal and fetal tissues that dilates the umbilical placental vasculature in vitro. To test the hypothesis that prostacyclin dilates the fetal placental circulation in vivo, we measured blood flow by the radioactive microsphere technique in six unanesthetized nea...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Parisi VM,Walsh SW

    更新日期:1989-04-01 00:00:00

  • Analysis of circulating annexin A5 parameters during pregnancy: absence of differences between women with recurrent spontaneous pregnancy losses and controls.

    abstract:OBJECTIVE:We investigated whether levels of annexin A5 (AnxA5), AnxA5 anticoagulant activity and binding, and anti-AnxA5 antibodies might be altered in women with previous histories of recurrent spontaneous pregnancy losses (RSPL) when tested during pregnancy. STUDY DESIGN:Ninety pregnant women with histories of 3 or ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Wu XX,Arslan AA,Wein R,Reutelingsperger CP,Lockwood CJ,Kuczynski E,Rand JH

    更新日期:2006-10-01 00:00:00

  • Lymphokine production during term human pregnancy: differences between peripheral leukocytes and decidual cells.

    abstract::Although the fetus is considered to be an "allograft" there is little information concerning the role of lymphokines in human pregnancy. Lymphokines are polypeptides secreted by stimulated lymphocytes that direct the immune response by enabling immune effector cells to communicate with each other. To characterize lymp...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Dudley DJ,Mitchell MD,Creighton K,Branch DW

    更新日期:1990-12-01 00:00:00

  • Sequential plasma angiogenic factors levels in women with suspected preeclampsia.

    abstract:BACKGROUND:Alterations in circulating angiogenic factors are associated with the diagnosis of preeclampsia and correlate with adverse perinatal outcomes during the third trimester. OBJECTIVE:Analysis of the sequential levels of plasma angiogenic factors among patients admitted for evaluation of preeclampsia. STUDY DE...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Baltajian K,Bajracharya S,Salahuddin S,Berg AH,Geahchan C,Wenger JB,Thadhani R,Karumanchi SA,Rana S

    更新日期:2016-07-01 00:00:00

  • Detection of genes that are differentially expressed during mouse embryogenesis by genetic trapping strategies.

    abstract:OBJECTIVE:Our objective was to identify novel genes that are expressed in temporally and spatially restricted patterns during mouse embryonic development and organogenesis. STUDY DESIGN:Two genetic trapping reporter constructs that lack transcriptional regulatory sequences were introduced independently into transcript...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Johnson MD,Mahon KA

    更新日期:1993-09-01 00:00:00

  • Regulation of CA 125 production by amnion and WISH cells in culture.

    abstract::Amnion and human amnion-derived WISH cells release CA 125 antigen into culture medium. CA 125 output was higher in WISH cells than in amnion cells. In this study we showed that release of the antigen is regulated, with both amnion and WISH cells responding in a similar manner to the tested agents. Release of CA 125 de...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Barbati A,Broccucci L,Anceschi MM,Cosmi EV

    更新日期:1991-05-01 00:00:00

  • Clinical significance of elevated mean arterial blood pressure in second trimester and threshold increase in systolic or diastolic blood pressure during third trimester.

    abstract::The purpose of this investigation was to determine the diagnostic value of an average mean arterial blood pressure in the second trimester of greater than or equal to 90 mm Hg and a threshold increase in diastolic blood pressure of greater than or equal to 15 mm Hg or in systolic blood pressure of greater than or equa...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章


    authors: Villar MA,Sibai BM

    更新日期:1989-02-01 00:00:00