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Obstetrics and Gynecology International
Volume 2012 (2012), Article ID 649070, 11 pages
http://dx.doi.org/10.1155/2012/649070
Research Article

Meta-Analysis of Maternal and Neonatal Outcomes Associated with the Use of Insulin Glargine versus NPH Insulin during Pregnancy

1Service de Gynécologie-Obstétrique, Hôpital Cochin-Saint Vincent de Paul, Cedex 14, 75674 Paris, France
2Outcomes Research, Novosys Health, Flemington, NJ 08822, USA
3Grimsdyke House, EN5 4ND London, UK
4Diabetes-Metabolism Franchise, Sanofi-Aventis France, Cedex 14, 75159 Paris, France
5Department of Medicine, Division of Endocrinology, Diabetes & Clinical Nutrition, Oregon Health and Science University, Portland, OR 97239, USA
6Institute of Cellular Medicine–Diabetes, Newcastle University, Newcastle upon Tyne NE2 4HH, UK

Received 22 November 2011; Revised 28 January 2012; Accepted 6 February 2012

Academic Editor: Russell K. Laros Jr.

Copyright © 2012 Jacques Lepercq et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

As glargine, an analog of human insulin, is increasingly used during pregnancy, a meta-analysis assessed its safety in this population. A systematic literature search identified studies of gestational or pregestational diabetes comparing use of insulin glargine with human NPH insulin, with at least 15 women in both arms. Data was extracted for maternal outcomes (weight at delivery, weight gain, 1st/3rd trimester H b A 1 c , severe hypoglycemia, gestation/new-onset hypertension, preeclampsia, and cesarean section) and neonatal outcomes (congenital malformations, gestational age at delivery, birth weight, macrosomia, LGA, 5 minute Apgar score > 7, NICU admissions, respiratory distress syndrome, neonatal hypoglycemia, and hyperbilirubinemia). Relative risk ratios and weighted mean differences were determined using a random effect model. Eight studies of women using glargine (331) or NPH (371) were analyzed. No significant differences in the efficacy and safety-related outcomes were found between glargine and NPH use during pregnancy.