ROME — Continuous glucose monitoring during pregnancy was linked to a significant reduction in median birth weight and macrosomia risk in a study of 71 women with type 1 or type 2 diabetes.
The randomized, open study also showed that pregnant women who wore the monitors for 5–7 days, at 4–6 weekly intervals, had better blood glucose control than did women who received standard prenatal care alone.
The study comprised 46 women with type 1 and 25 women with type 2 diabetes. A total of 38 women were randomized to use continuous glucose monitoring (CGM) as an educational tool to inform decision making and future therapeutic changes; the remaining 33 women were randomized to standard care, study investigator Dr. Helen R. Murphy reported Sept. 8 at the annual meeting of the European Association for the Study of Diabetes.
All statistical analyses were performed on an intention-to-treat basis, said Dr. Murphy of Ipswich (England) Hospital.
At weeks 32–36 of gestation, hemoglobin A1c levels were significantly lower in the CGM group than in the standard care group (5.8% vs. 6.4%).
In addition, infants born to women in the CGM group were significantly less likely to have a high birth weight than were those born to women in the standard care group. The mean standard deviation (SD) score for birth weight was 0.9 for infants in the CGM group and 1.6 for those in the standard care group.
“What is even more striking is the complete absence of small-for-gestational age babies in women randomized to standard antenatal care,” Dr. Murphy said.
She also noted that there were two infants that had SD scores of above three in the CGM arm, but their mothers had withdrawn from the study before completion.
Compared with children in the standard care arm, the children in the CGM group were at decreased risk (odds ratio 0.36) of macrosomia, defined as a birth weight in the 90th percentile or higher.
CGM was well accepted by the women, according to Dr. Murphy, adding that they wore the monitors on their flank at least once a trimester. The monitors were provided free of charge by Medtronic UK. Ipswich Hospital Diabetes Centre Charity Research Fund and Diabetes UK supported the investigator-led study.
Children in the continuous glucose monitoring group had a 64% lower risk of macrosomia. DR. MURPHY