RE: [ozmidwifery] Henci Goer's Article on GD

[Kelly @ BellyBelly]

Bah, should have thought about looking there, I do it so often… thanks Mary… J   Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Mary Murphy Sent: Saturday, 5 August 2006 9:39 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Henci Goer's Article on GD   From the The Cochrane Database of Systematic Reviews 2006 Issue 3 :  Background “Gestational diabetes and impaired glucose tolerance (IGT) in pregnancy affects between 3 and 6% of all pregnancies and both have been associated with pregnancy complications. A lack of conclusive evidence has led clinicians to equate the risk of adverse perinatal outcome with pre-existing diabetes. Consequently, women are often intensively managed with increased obstetric monitoring, dietary regulation, and in some cases insulin therapy. However, there has been no sound evidence base to support intensive treatment. The key issue for clinicians and consumers is whether treatment of gestational diabetes and IGT will improve perinatal outcome.” Main results  Three studies with a total of 223 women were included. All three included studies involved women with IGT. No trials reporting treatments for gestational diabetes met the criteria. There are insufficient data for any reliable conclusions about the effect of treatments for IGT on perinatal outcome. The difference in abdominal operative delivery rates is not statistically significant (relative risk (RR) 0.86, 95% confidence interval 0.51 to 1.45) and the effect on special care baby unit admission is also not significant (RR 0.49, 95% confidence interval (CI) 0.19 to 1.24). Reduction in birthweight greater than 90th centile (RR 0.55, 95% CI 0.19 to 1.61) was not found to be significant. This review suggests that an interventionist policy of treatment may be associated with a reduced risk of neonatal hypoglycaemia (RR 0.25, 95% CI 0.07 to 0.86). No other statistically significant differences were detected. A number of outcomes are only reported by one study resulting in a small sample and wide confidence intervals. Authors' conclusions There are insufficient data for any reliable conclusions about the effects of treatments for impaired glucose tolerance on perinatal outcome. Looks like the studies have not been done.  MM       From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Michelle Windsor Sent: Saturday, 5 August 2006 6:51 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Henci Goer's Article on GD   I agree. There seems to be a real misconception even amongst obstetricians that gestational diabetes has the same risks as pre-existing diabetes.  A couple of years ago I did a bit of research on it for my masters and could find no evidence that this was so.  And according to cochrane the  OGT test is not reproducible 50-70% of the time.   Cheers Michelle Mary Murphy <[EMAIL PROTECTED]> wrote: The best way for those who disagree is to find the definitive studies that address all of Henci’s points. If is such an important issue, those studies would be available for us all to read. There is harm being done to mothers and babies by the definition of Gestational diabetes.  MM   What are everyone’s thoughts on Henci Goer’s GD article? It’s caused a bit of a stir in my GD forum: http://www.bellybelly.com.au/forums/showthread.php?p=382564 but I don’t feel that I know enough about it to comment… Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support      Send instant messages to your online friends http://au.messenger.yahoo.com