{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:36:54Z","timestamp":1747183014890,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>It is unclear whether early treatment of women with a first antenatal HbA1c of 41\u201346\u00a0mmol\/mol improves pregnancy outcomes. Our Hospital Guideline (HG) recommends early treatment, but the New Zealand GDM Guideline (NG) recommends lifestyle advice and a 75\u00a0g OGTT at 24\u201328\u00a0weeks\u2019 gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to compare, at a single centre, pregnancy outcomes in women who were treated before 24\u00a0weeks (HG group) with women who were managed according to the NG. Our hypothesis was that earlier treatment was associated with lower rates of pre\u2010eclampsia and preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Women who had a first antenatal HbA1c of 41\u201346\u00a0mmol\/mol between January 2016 and December 2019 and delivered at our institution before August 2020 were included. Baseline characteristics, management of GDM and pregnancy outcomes were collected. Univariable and multivariable analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 141 women in the HG group and 67 women in the NG group. The NG group had fewer Indian\/Chinese\/Other Asian women (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) and BMI was higher (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.05). Women in the NG group, compared with the HG group, had more infants with a customised birthweight &gt;90<jats:sup>th<\/jats:sup> centile (19.4% vs 7.8%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.014). In addition, after adjusting for ethnicity and BMI, women in the NG group had higher rates of pre\u2010eclampsia (ORa (95th CI), 3.7 (1.1\u201313.3), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04) and preterm birth (2.8 (1.1\u20137.0), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Management according to our Hospital Guideline, compared with the National GDM Guideline, was associated with lower rates of pre\u2010eclampsia, preterm birth and infants with a customised birthweight &gt;90<jats:sup>th<\/jats:sup> centile.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13476","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T15:23:59Z","timestamp":1642087439000},"page":"395-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early diabetes treatment is associated with improved outcomes in pregnant women with a first antenatal HbA1c of 41\u201346\u00a0mmol\/mol"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8406-3452","authenticated-orcid":false,"given":"Janet A.","family":"Rowan","sequence":"first","affiliation":[{"name":"National Women\u2019s Health at Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-6652","authenticated-orcid":false,"given":"Lynn","family":"Sadler","sequence":"additional","affiliation":[{"name":"Women\u2019s Health National Women\u2019s Health at Auckland City Hospital ADHB  Auckland New Zealand"},{"name":"Department of Obstetrics and Gynaecology University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1848"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci20-0055"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892\u2010015\u20100698\u2010y"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12812"},{"key":"e_1_2_7_6_1","unstructured":"Ministry of Health.Screening diagnosis and management of gestational diabetes in New Zealand: a clinical practice guideline 2014.www.health.govt.nz"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010018493"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12399"},{"key":"e_1_2_7_9_1","unstructured":"GardosiJ WilliamsA HughO FrancisA.Customised centile calculator. GROW v6.7.8 2016. Gestation Networkwww.gestation.net"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12166"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20101312"},{"key":"e_1_2_7_12_1","first-page":"390","article-title":"Role of first\u2010trimester HbA1c as a predictor of adverse obstetric outcomes in a multiethnic cohort","volume":"102","author":"Ma\u00f1\u00e9 L","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1687"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156926"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13476","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13476","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T06:54:09Z","timestamp":1692946449000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,13]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/ajo.13476"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13476","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2022,1,13]]},"assertion":[{"value":"2022-01-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}