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Trial registered on ANZCTR
Registration number
ACTRN12617000695303
Ethics application status
Approved
Date submitted
4/05/2017
Date registered
15/05/2017
Date last updated
8/01/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Macrosomia rates in women with diet-controlled gestational diabetes
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Scientific title
Macrosomia rates in women with diet-controlled gestational diabetes: a retrospective case-control study
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Secondary ID [1]
291856
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Gestational Diabetes
303126
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Macrosomia
303127
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Condition category
Condition code
Reproductive Health and Childbirth
302574
302574
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0
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Antenatal care
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Reproductive Health and Childbirth
302575
302575
0
0
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Complications of newborn
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Metabolic and Endocrine
302704
302704
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0
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Diabetes
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
A retrospective case-control study in which all patients with diet-controlled gestational diabetes mellitus (GDM) and singleton pregnancies in a single calendar year (2014) were considered for inclusion in the study. These cases were individually matched to controls without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately). Each participant was assessed at a single time point at the birth of their child.
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Intervention code [1]
297968
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Not applicable
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Comparator / control treatment
The control group were pregnant women without GDM and without type 1 or 2 diabetes. They were matched according to parity, age and BMI.
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Control group
Active
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Outcomes
Primary outcome [1]
301988
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Primary outcomes were macrosomia defined by birth weight >90th centile.
Australian Birth Weight charts were used to classify weights >90th% and >95th% centiles.
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Assessment method [1]
301988
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Timepoint [1]
301988
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Weight of infant at birth
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Primary outcome [2]
302104
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birthweight > 95th%
Australian Birth Weight charts were used to classify weights >90th% and >95th% centiles.
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Assessment method [2]
302104
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Timepoint [2]
302104
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Weight of infant at birth
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Secondary outcome [1]
334447
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Nil
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Assessment method [1]
334447
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Timepoint [1]
334447
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Nil
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Eligibility
Key inclusion criteria
We compared a cohort of patients with gestational diabetes managed by dietary measures with a concurrent pregnant control group matched for age, parity and body mass index. All patients with diet-controlled gestational diabetes with singleton pregnancies in a single calendar year in 2014 at the antenatal clinics of the Royal Women's Hospital, Melbourne were considered for inclusion in the study. Patients were identified using data generated from the hospital’s electronic medical record system.
Control patients were selected from those without gestational, type 1 or type 2 diabetes attending for obstetric care at the same hospital. Cases and controls were matched for parity (exactly if possible, otherwise nearest available), age (within mutually exclusive five year groups partitioning the clinic patient age range, 20-24, 25-29, 30-34, 35-39, 40-44 and 45-49) and a similar partitioning of the clinic BMI range (within 5 units, 16-20, 21-25, 26-30, 31-35, 36-40, 41-45, 46-50 and 51-55). Controls were selected from the same calendar year (2014), with a date of delivery as close as possible to the date of delivery of the gestational diabetic case patient.
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Patients with multiple pregnancies were excluded, as were patients whose body mass index was unrecorded.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Case control
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Timing
Retrospective
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Statistical methods / analysis
Summary statistics were reported as mean with standard deviation, and/or median, interquartile range (IQR) and range, as appropriate. The closeness of 1:1 matching between cases and controls was assessed as differences within matched pairs of maternal age, BMI and parity. Matched case control gestational diabetes data were analysed with regression models using conditional logistic regression models which returned estimated adjusted odds ratios for the presence of (variously defined) macrosomia associated with maternal gestational diabetes, adjusted for maternal age, BMI, gravidity, parity, baby gender and estimated gestational age (EGA). Data were analysed using Stata version 14.2. No adjustments were made for multiple comparisons.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
4/01/2017
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Date of last participant enrolment
Anticipated
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Actual
18/01/2017
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Date of last data collection
Anticipated
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Actual
18/01/2017
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Sample size
Target
400
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Accrual to date
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Final
404
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
8020
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The Royal Women's Hospital - Parkville
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Recruitment postcode(s) [1]
15891
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
296355
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Self funded/Unfunded
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Name [1]
296355
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NA
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Address [1]
296355
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NA
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Country [1]
296355
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Primary sponsor type
Hospital
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Name
Royal Women's Hospital, Department of Maternal Fetal Medicine and Pregnancy Research Centre
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Address
Flemington Road
Parkville 3052
Victoria
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Country
Australia
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Secondary sponsor category [1]
295287
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University
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Name [1]
295287
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University of Melbourne
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Address [1]
295287
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Grattan St
Parkville 3052
Victoria
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Country [1]
295287
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297585
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Royal Women's Human Research Ethics Committee
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Ethics committee address [1]
297585
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Royal Women's Hospital Flemington Road Parkville 3052 Victoria
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Ethics committee country [1]
297585
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Australia
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Date submitted for ethics approval [1]
297585
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Approval date [1]
297585
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21/12/2016
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Ethics approval number [1]
297585
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AQA 16/01
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Summary
Brief summary
Background: Current data on the rates of macrosomia in women with gestational diabetes mellitus (GDM) are heterogenous. No study has specifically examined macrosomia rates in women with diet-controlled gestational diabetes. Aims: To compare the rates of macrosomia between mothers with diet-controlled GDM to mothers without diabetes mellitus. Methods: A retrospective case-control study in which all patients with diet-controlled GDM and singleton pregnancies in a single calendar year were considered for inclusion in the study. These cases were individually matched to controls without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately). Results: 217 cases were identified with diet-controlled gestational diabetes, out of a total of 7185 births. 15 cases were excluded, leaving 202 cases in total. A total of 16 babies were >90th% and 10 were >95th% in the diet-controlled GDM group. 21 babies were >90th% and 11 were 95th% in the control group. Conclusions: Our findings suggest that macrosomia is not increased in women with diet-controlled GDM, so women with diet-controlled GDM may not require extra surveillance for fetal growth beyond that of the normal obstetric population. Provided women attend appropriate initial consultations with a diabetes educator and a dietician, are linked in with an experienced maternity centre and care-givers are familiar with blood-glucose targets, serious consideration should be given to new guidelines allowing women with diet-controlled diabetes to have obstetric care within lower risk pathways.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
74522
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Dr Fatima Vally
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Address
74522
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Royal Women's Hospital
Flemington Road
Parkville 3052
Victoria
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Country
74522
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Australia
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Phone
74522
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+61418592864
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Fax
74522
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Email
74522
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[email protected]
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Contact person for public queries
Name
74523
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Fatima Vally
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Address
74523
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Royal Women's Hospital
Flemington Road
Parkville 3052
Victoria
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Country
74523
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Australia
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Phone
74523
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+61418592864
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Fax
74523
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Email
74523
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[email protected]
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Contact person for scientific queries
Name
74524
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Fatima Vally
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Address
74524
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Royal Women's Hospital
Flemington Road
Parkville 3052
Victoria
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Country
74524
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Australia
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Phone
74524
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+61418592864
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Fax
74524
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Email
74524
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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