Real-time CGM use reduces odds of LGA births in pregnant women with gestational diabetes

In pregnancies complicated by gestational diabetes, the use of continuous glucose monitoring in real time (rt-CGM) appears to reduce the likelihood of delivering large-for-gestational-age newborns, as shown in a study.

The study included 375 women with a singleton pregnancy who received a diagnosis of gestational diabetes at a mean of 25.2 weeks of gestation according to the International Association of the Diabetes and Pregnancy Study Groups criteria. These women were randomly assigned to use rt-CGM until delivery (n=190) or perform self-monitoring of blood glucose (SMBG) (n=185). Those assigned to SMBG used blinded CGM for 10 days after randomization and at 36–38 weeks.

LGA newborns were the primary endpoint. Secondary endpoints included requirement for glucose-lowering medication, CGM metrics, and nonglycaemic maternal and neonatal outcomes.

The proportion of LGA newborns was 4 percent in the rt-CGM group vs 10 percent in the SMBG group (odds ratio [OR], 0.32, 95 percent confidence interval [CI], 0.10–0.87; p=0.014).

The proportion of small-for-gestational-age (SGA) neonates were 19 percent and 13 percent in the rt-CGM and SMBG groups, respectively (OR, 1.59, 95 percent CI, 0.86–2.99; p=0.11). The overall prevalence of SGA infants was higher than expected and possibly related to the tight glycaemic control in the cohort, according to researchers.

Serious adverse events occurred in 12 percent of women in the rt-CGM group and in 15 percent in the SMBG group (OR, 0.77, 95 percent CI, 0.42–1.40; p=0.39).