Perinatal outcomes in pregnancies managed with antenatal insulin glargine.

Full Abstract

We compared perinatal outcomes in pregnancies in which insulin glargine was used in the management of patients with pregnancies in which standard insulin therapy was used at a single institution. A retrospective analysis of 114 pregnant patients with diabetes (pregestational or gestational) managed at a single center between January 2004 and August 2006 was undertaken. Sixty-five patients managed with insulin glargine were compared with 49 patients managed with neutral protamine Hagedorn (NPH) insulin. Both groups were also treated with short-acting insulin (either regular, lispro, or aspart insulin). Maternal age, parity, prepregnancy weight, body mass index, duration of diabetes, hemoglobin A (1C) (at entry and final recorded) and gestational age at entry were similar for each group (glargine and NPH). Thirty patients had gestational diabetes (18 glargine and 12 NPH); there were no differences in numbers of patients in higher-order White's classification between the two groups. Cesarean section for obstetric reasons included labor abnormalities, malpresentation, fetal distress, and suspected macrosomia. There were no differences in gestational age at delivery, birth weight, preeclampsia, or frequency of cesarean section (total or for obstetric reasons). The frequency of shoulder dystocia was higher in the NPH group. Regarding neonatal outcomes, gestational age at delivery, birth weight, Apgar scores, admission to the neonatal intensive care unit, respiratory distress syndrome, hypoglycemia, and congenital anomalies were similar between the two groups. From this retrospective analysis, no adverse maternal or neonatal effects were seen from maternal administration of insulin glargine. A larger multicenter study is needed to confirm these findings. This preliminary report suggests that use of insulin glargine during pregnancy can be considered if maternal metabolic control is suboptimal using the standard split-mix regimen. Thieme Medical Publishers.

Author information

Author/s: Egerman, Robert S (RS); Ramsey, Risa D (RD); Kao, Lu W (LW); Bringman, Jay J (JJ); Haerian, Haleh (H); Kao, Jerome L (JL); Bush, Andrew J (AJ);

Affiliation: Department of Obstetrics and Gynecology, Morgantown, WV, USA. regerman(-atsign-)utmem.edu

Journal and publication information

Publication Type: Journal Article

Journal: American journal of perinatology (Am J Perinatol), published in United States. (Language: eng)

Reference: 2009-Sep; vol 26 (issue 8) : pp 591-5

Dates: Created 2009/08/17; Completed 2009/10/27;

PMID: 19370512, status: MEDLINE (last retrieval date: 10/27/2009, IMS Date: )

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Diabetes, Gestational - drug therapy
Female
Humans
Hypoglycemic Agents - therapeutic use
Infant, Newborn

Infant, Newborn
Insulin - analogs & derivatives; therapeutic use
Insulin, NPH
Pregnancy
Pregnancy Outcome
Pregnancy in Diabetics - drug therapy

Associated Chemicals: Hypoglycemic Agents (0) ; glargine (0) ; insulin aspart (0) ; Insulin (11061-68-0) ; insulin LISPRO (133107-64-9) ; Insulin, NPH (53027-39-7)

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