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Associations of dietetic management with maternal and neonatal health outcomes in women diagnosed with gestational diabetes: a retrospective cohort study
journal contribution
posted on 2019-12-01, 00:00 authored by G Absalom, J Zinga, Claire MargerisonClaire Margerison, Paige van der PligtPaige van der PligtBackground: In 2010, the recommended diagnostic thresholds for gestational diabetes mellitus (GDM) were amended, which has increased GDM diagnoses, as well as pressure on the services involved in GDM management, specifically impacting dietetic workloads. The present study examined the associations between dietetic intervention in women with GDM and maternal and neonatal health outcomes. Methods: The present study involved 1233 adult women with GDM who delivered at The Royal Women's Hospital (RWH), Melbourne, Australia, between July 2015 and May 2017. Retrospective data assessing GDM-care (therapy type, diagnosis time and model of care, maternal and neonatal health outcomes, and outpatient dietetic consultations) were retrieved from patient medical records. Unadjusted and adjusted linear and logistic regression were used to assess associations of GDM care dietetic intervention and GDM care and dietetic intervention with maternal and neonatal health outcomes. Results: Women receiving dietetic intervention had a decreased likelihood of infant admission to the neonatal intensive care unit or special care nursery than women who not receiving dietetic intervention [adjusted odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.22–0.75; P = 0.004). Women requiring pharmacotherapy were more likely to experience maternal complications (adjusted OR = 3.13, 95% CI = 2.23–4.41; P < 0.001) and had a greater number of dietetic consultations (β-coefficient = 0.28, 95% CI = 0.17–0.39; P < 0.001) compared to women managed through diet. Conclusions: Dietetic intervention plays a key role in optimising maternal and neonatal health outcomes for women with GDM. Exploring further the impact of dietetic intervention in women diagnosed with GDM is key with respect to understanding the optimal delivery of care for these women. The type and number of consultations included in a dietetic intervention should be investigated further.
History
Journal
Journal of human nutrition and dieteticsVolume
32Issue
6Pagination
728 - 736Publisher
WileyLocation
Chichester, Eng.Publisher DOI
ISSN
0952-3871eISSN
1365-277XLanguage
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2019, The British Dietetic Association Ltd.Usage metrics
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