Gestational diabetes mellitus in Italy: a multicenter study

OBJECTIVE: This prospective study evaluated the impact of gestational diabetes on maternal and fetal outcome in a large cohort of women with gestational diabetes mellitus (GDM) followed up using standardized clinical criteria. STUDY DESIGN: Between 1999 and 2003, we collected 3465 GDM women from 31 Italian regional obstetric or diabetes centers, recording the time and mode of delivery, gestational hypertension, pre-eclampsia, eclampsia, congenital malformations, and neonatal mortality, comparing findings with the Italian general pregnant population. RESULTS: The rate of cesarean sections was 34.9% and macrosomia 8.7% (33.2 and 7.4%, respectively, in the general population, p=ns). The stillbirth and neonatal mortality rates were no different in GDM patients and normal pregnancies (0.34% vs. 0.30%, p=0.176 and 0.29% vs. 0.32%, p=0.748), but the former had twice as many newborn with congenital malformations (2.05% vs. 0.89%, p