BJOG. 2007 Apr;114(4):453-7.
Use of insulin glargine during pregnancy: a
case-control pilot study.
Price N, Bartlett C, Gillmer M.
Department of Obstetrics and Gynaecology, John
Radcliffe Hospital, Oxford, UK. price@clara.co.uk
Objectives:
To determine whether the use of insulin
glargine during pregnancy is associated with an
increase in the incidence of fetal macrosomia or
adverse neonatal outcome.
Design:
A matched
case-control study.
Setting:
Women's Centre, John
Radcliffe Hospital, Oxford, UK.
Sample:
Sixty-four
pregnant women treated with insulin during their
pregnancies, 20 with type I diabetes and 44 with
gestational diabetes.
Methods:
Two groups of women
were compared in matched pairs. A study group of 32
pregnant women with diabetes treated with insulin
glargine during their pregnancy and a control group
of 32 pregnant women treated with an
intermediate-acting human insulin (isophane or
insulin zinc suspension) and matched for weight at
booking, height, gestation at delivery, parity,
fetal sex, duration of insulin use in pregnancy and
glycaemic control during the third trimester of
pregnancy (glycosylated haemoglobin [HbA(1c)]
concentration and mean blood glucose concentration).
Main Outcome Measures:
Birthweight, centile
birthweight, the incidence of fetal macrosomia (birthweight
> 90th percentile) and neonatal morbidity in the two
study groups.
Results:
There was no significant
difference between the birthweight or centile
birthweight of babies born to the women treated with
insulin glargine during pregnancy and that of the
babies born to those in the control group treated
with intermediate-acting human insulin. The overall
incidence of fetal macrosomia was 12/32 (37.5%) in
the insulin glargine group and 13/32 (40.6%) in the
control group. There was no significant difference
in neonatal morbidity between the groups.
Conclusions:
The results of this pilot study
indicate that insulin glargine treatment during
pregnancy does not appear to be associated with
increased fetal macrosomia or neonatal morbidity.
