Associations of dietetic intervention and maternal and neonatal outcomes in women with gestational diabetes

Ms Julia Zinga1, Dr Paige  van der Pligt2, Dr Claire Margerison2, Ms Gina Absalom2

1Royal Women’s Hospital, St Helena, Australia, 2School of Exercise and Nutrition Science, Deakin University, Burwood, Australia

Abstract:

Aims:
Dietitians play a pivotal role in gestational diabetes (GDM) management, yet, limited literature has assessed the impact of dietetic intervention in women with GDM. This study aimed to assess the associations between dietetic intervention and aspects of care in women with GDM, and a range of maternal and neonatal outcomes.

Methods:
This was a retrospective cohort study, of 1233 adult women diagnosed with GDM in a singleton pregnancy, who delivered at the Royal Women’s Hospital (RWH) between 2015 and 2017. A medical records audit determined the number of dietetic consultations per patient, and aspects of care: medical nutrition therapy vs added pharmacotherapy; specialist diabetes clinic care vs routine antenatal clinic; and a range of maternal and neonatal outcomes. Adjusted linear and logistic regression was used to analyse associations.

Results:
Women requiring pharmacotherapy had a greater number of dietetic consultations compared to women managed solely with medical nutrition therapy (β-coef (95%CI) =0.28(0.17-0.39)), (p<0.001). Women who received 1 or more dietetic consultations had a decreased likelihood of infant admission to the neonatal intensive care unit (NICU) or special care nursery (SCN) ([OR] 0.41, 95% CI 0.22-0.75; P=0.004), compared to women who didn’t receive dietetic intervention. No associations were noted between number of dietetic consultations and maternal outcomes or other neonatal health outcomes.

Significance:
Dietetic intervention in GDM, within a comprehensive healthcare package, is associated with fewer infant admissions to NICU or SCN. Further research should assess the impact of dietetic intervention on optimising maternal and neonatal health in women with GDM.

Biography:

Julia Zinga is a Diabetes Dietitian and holds a Bachelor of Health Science (Nutrition & Dietetics) from The University of Newcastle. The majority of Julia’s dietetic career has been in the field of diabetes, providing dietary counselling to people of all ages with diabetes. Since 2014, Julia has worked as Diabetes Dietitian at Royal Women’s Hospital, Melbourne, working in the multidisciplinary diabetes unit to support women with Type 1 or Type 2 diabetes who are pregnant or planning pregnancy, and women with gestational diabetes.