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To compare the timing, duration, and severity of corticosteroid-associated hyperglycemia in pregnant women with and without diabetes mellitus (DM). An observational study was conducted of pregnant women with DM and controls who received corticosteroids. Median glucose levels were calculated over 4-hour intervals after the first dose of corticosteroid with a continuous glucose monitor. A glucose level increase of at least 15% above baseline was considered significant. Nine pregnant women participated in this study (six with DM and three without DM). Elevations of glucose levels occurred at hour 20, 44, and 68 in both groups and lasted for up to 4 hours. In those with DM, glucose levels increased 33 to 48%, whereas in those without DM, glucose levels rose 16 to 33%. Several, relatively short episodes of glucose elevation occur in response to corticosteroids, and are more pronounced in diabetic women. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the frequency of abnormal fetal growth in women with diabetes mellitus (DM) using population-based birth weight (pop BW) percentiles compared with customized birth weight (cust BW) percentiles, which include adjustments for maternal race, parity, height, weight, and fetal sex. The study design comprised a retrospective cohort of singleton DM pregnancies delivered over a 1-year period (June 2007 to May 2008) from a single tertiary care university-based medical center. Inclusion criteria were gestational age >20 weeks at delivery, live birth, and absence of major chromosomal/structural abnormalities. Small for gestational age (SGA), <10th percentile, and large for gestational age (LGA), >90th percentile pregnancies were categorized based on pop BW or cust BW standards. There were significant differences in the rates of SGA (p < 0.004) and LGA (p < 0.001) between cust BW and pop BW methods. When comparing the two methods, pop BW did not identify 13/16 (81%) of SGA and 23/39 (59%) of LGA babies defined by cust BW methods. The use of cust BW calculation in a diabetic population identified a greater percentage of neonates with pathologic fetal growth compared with pop BW standards, suggesting that the population standard may underdiagnose abnormal fetal growth in diabetic pregnancies. [ABSTRACT FROM AUTHOR]

We sought to determine the rate and timing of full publication of clinical trials initially presented as abstracts at a national maternal-fetal medicine (MFM) research meeting and identify factors associated with publication status. All abstracts presented over a 3-year period (2000 to 2002) at the Society of MFM Annual Meeting were reviewed. Abstracts reporting outcomes for prospective, interventional research studies with human subjects were included. Multiple electronic databases were searched for evidence of full publication with a minimum of 5-year follow-up. The reporting characteristics of abstracts that were published as full research reports were compared with those not published. During the study period, 2012 abstracts were presented and 90 met all study criteria (4.5%). Of these, 55.6% ( N?=?50) were subsequently published as full research reports. There were no differences in the use of placebo, randomization, or blinding. Studies reaching full publication had larger sample size (median 174 [12 to 4165] versus 96 [22 to 1039]; P?=?0.02) and were more likely to report treatment differences (60% versus 32.5% P?=?0.009). After adjusting for confounding factors, the reporting of treatment differences remained associated with full publication (odds ratio 3.3 [95% confidence interval 1.3 to 8.0]; P?=?0.01). Full publication of clinical trials occurred more often if treatment differences were present. Positive publication bias exists in MFM research. [ABSTRACT FROM AUTHOR]

We evaluated the relationship between duration of labor induction and successful vaginal delivery (VD) in nulliparous women at term. Nulliparous women with singleton pregnancies ? 37 weeks who underwent labor induction at a single institution were studied. Exclusion criteria were nonvertex presentation, stillbirth, fetal chromosomal/structural abnormalities, spontaneous labor, and spontaneous rupture of membranes. VD rates and maternal/neonatal outcomes were evaluated and compared with respect to the duration from induction to delivery. Over the 1-year study period, 340 women met all criteria. Seventy-five percent achieved VD (n = 255), 40.6% of whom had rate of cervical dilation in active labor < 1.0 cm/hour. Women requiring cesarean delivery were more likely to have fetal acidemia, admission to the neonatal intensive care unit, chorioamnionitis, and endometritis. There was no association with prolonged induction to delivery intervals and adverse maternal/neonatal outcomes. In our population, only 5.7% of nulliparous women undergoing labor induction at term remain undelivered at 48 hours. Of women achieving VD, > 40% had rate of cervical dilation in active labor < 1.0 cm/hour. [ABSTRACT FROM AUTHOR]