human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We set out to reevaluate the hypothesis that high normal ( negative ) results of 50 g oral glucose challenge test or high normal glucose level on 100 g oral glucose tolerance test are associated with complications of pregnancy and delivery .  This was a prospect i ve study involving 735 nondiabetic women . The first group ( n=352 ) was made up of pregnant women with normal 50 g oral glucose challenge test without previous history of diabetes mellitus or gestational diabetes . The second group ( n=383 ) was made up of pregnant women without previous history of diabetes mellitus or gestational diabetes with an abnormal 50 g oral glucose challenge test and with normal 100 g oral glucose tolerance test and not more than one previous delivery . In nondiabetic women , we demonstrated a positive correlation between high normal 50 g glucose challenge test values and the incidence of preeclampsia , caesarean section rate , macrosomia , neonatal hyperlipidaemia and minor congenital abnormalities . We failed to confirm any relationship to any pregnancy complication in pregnant women with 2-hour glucose levels in the range 6.7 - 9.1 mmol/l on the 100 g oral glucose tolerance test . We have demonstrated a positive relationship between the incidence of premature rupture of membranes and 1-hour glucose level , caesarean section rate and maternal 1-hour glucose level or 1-hour glucose level minus fasting glucose level of 4.2 mmol/l , instrumental delivery rate and maternal 3-hour glucose level , incidence of neonatal macrosomia and 1-hour glucose level , and incidence of neonatal hyperlipidaemia and at least one high but normal glucose level on the 100 g oral glucose tolerance test . With regard to pregnancy and delivery complications there were no significant difference if the high normal value is on the 50 g glucose challenge test or on the 100 g oral glucose tolerance test . It is concluded that one high normal 100 g oral glucose tolerance test or high normal 50 g glucose challenge test are associated with adverse pregnancy and delivery outcome . Nondiabetic women with 50 g glucose challenge test value of 6.1 mmol/l and /or 100 g oral glucose tolerance test values of 5 mmol/l have a favourable pregnancy and delivery outcome OBJECTIVE —We investigated the effects of normal variations in maternal glycemia on birth size and other birth outcomes . RESEARCH DESIGN AND METHODS —Women in two unselected birth cohorts , one retrospective ( n = 3,158 ) and one prospect i ve ( n = 668 ) , underwent an oral glucose challenge at 28 weeks of gestation . In the retrospective study , glycemia was linked to routine birth records . In the prospect i ve study , offspring adiposity was assessed by skinfold thickness from birth to age 24 months . RESULTS —In the retrospective study , within the nondiabetic range ( 2.1–7.8 mmol/l ) , each 1 mmol/l rise in the mother 's 60-min glucose level was associated with a ( mean ± SEM ) 2.1 ± 0.8 % ( P = 0.006 ) rise in absolute risk of assisted vaginal delivery , a 3.4 ± 0.8 % ( P < 0.0001 ) rise in emergency cesarean delivery , a 3.1 ± 0.7 % ( P < 0.0001 ) rise in elective cesarean delivery , and a 46 ± 8 g ( P < 0.0001 ) increase in offspring birth weight . In the prospect i ve study , fetal macrosomia ( birth weight > 90th centile ) was independently related to the mother 's fasting glucose ( odds ratio 2.61 per + 1 mmol/l [ 95 % CI 1.15–5.93 ] ) and prepregnancy BMI ( 1.10 per + 1 kg/m2 [ 1.04–1.18 ] ) . The mother 's higher fasting glycemia ( P = 0.004 ) , lower insulin sensitivity ( P = 0.01 ) , and lower insulin secretion ( P = 0.02 ) were independently related to greater offspring adiposity at birth . During postnatal follow-up , the correlation between the mother 's glycemia and offspring adiposity disappeared by 3 months , whereas prepregnancy BMI was associated with offspring adiposity that was only apparent at 12 and 24 months ( both P < 0.05 ) . CONCLUSIONS —Prepregnancy BMI , pregnancy glycemia , insulin sensitivity , and insulin secretion all contribute to offspring adiposity and macrosomia and may be separate targets for intervention to optimize birth outcomes and later offspring health Aims /hypothesisTo determine the extent to which gestational fasting and postload levels of glucose explain differences in infant fat mass between UK-born Pakistani and white British infants . Methods Analyses were undertaken in a prospect i ve pregnancy cohort study of 1,415 women and their singleton live-born infants ( 629 white British and 786 Pakistani ) . Infant fat mass was assessed by cord-blood leptin levels and fetal insulin secretion by cord-blood insulin levels . Maternal OGTTs were completed at 26–28 weeks of gestation . Results Pakistani women had higher fasting and postload glucose levels and greater incidence of gestational diabetes than white British women .  Higher fasting and postload glucose levels were associated with higher cord-blood levels of insulin and leptin in all participants , irrespective of ethnicity . Cord-blood leptin levels were 16 % ( 95 % CI 6 , 26 ) higher in Pakistani than in white British infants . After adjustment for fasting glucose levels , this difference attenuated to 7 % ( −3 , 16 ) , and with additional adjustment for cord-blood insulin levels it attenuated further to 5 % ( −4 , 14 ) . Path analyses supported the hypothesis that fasting glucose levels mediate the relationship of Pakistani ethnicity to greater fat mass at birth , as measured by cord-blood leptin levels ; on average , 19 % of this mediation involved fetal insulin secretion . Postload glucose levels did not act as an important mediator of ethnic differences in cord-blood leptin levels . Results were very similar when 130 women with gestational diabetes were removed . Conclusions /interpretationThese novel findings suggest a role of maternal pregnancy glycaemia in mediating differences in fat mass between Pakistani and white British infants Aims /hypothesisGestational diabetes mellitus ( GDM ) is associated with increased risks to mother and child , but globally agreed diagnostic criteria remain elusive . Identification of women with GDM is important , as treatment reduces adverse outcomes such as perinatal death , shoulder dystocia and neonatal hypoglycaemia . Recently , the UK ’s National Institute for Health and Care Excellence ( NICE ) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups ( IADPSG ) criteria endorsed by the WHO . The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria . Methods Data from 25,543 consecutive singleton live births ( 2004–2008 ) were obtained retrospectively from hospital records . Women were screened with a r and om plasma glucose ( RPG ; 12–16 weeks ) and a 50 g glucose challenge test ( GCT ; 26–28 weeks ) . If RPG > 7.0 mmol/l , GCT > 7.7 mmol/l or symptoms were present , a 75 g OGTT was offered ( n = 3,848 ) . Results In this study , GDM prevalence was 4.13 % ( NICE 2015 ) and 4.62 % ( IADPSG ) . Women who ‘ fell through the net ’ , testing NICE-negative but IADPSG-positive ( n = 387 ) , had a higher risk of having a large-for-gestational-age ( LGA ) infant ( birthweight > 90th percentile for gestational age ; adjusted OR [ 95 % CI ] 3.12 [ 2.44 , 3.98 ] ) , Caesarean delivery ( 1.44 [ 1.15 , 1.81 ] ) and polyhydramnios ( 6.90 [ 3.94 , 12.08 ] ) compared with women with negative screening results and no OGTT ( n = 21,695 ) . LGA risk was highest among women with fasting plasma glucose 5.1–5.5 mmol/l ( n = 167 ) : the mean birthweight was 350 g above that of the reference population and 37.7 % of infants were LGA . Conclusions /interpretationThe IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria Background — Maternal diabetes mellitus in pregnancy results in greater  offspring adiposity  at birth . It is unclear whether it is associated with greater adiposity into adulthood , and if so , whether this is via intrauterine mechanisms or shared familial characteristics . Methods and Results — A record-linkage prospect i ve cohort study of 280 866 singleton-born Swedish men from 248 293 families was used to explore the intrauterine effect of maternal diabetes mellitus on offspring body mass index ( BMI ) in early adulthood . Maternal diabetes mellitus during pregnancy was associated with greater mean BMI at age 18 in their sons . The difference in BMI was similar within brothers and between nonsiblings . BMI of men whose mothers had diabetes mellitus during their pregnancy was on average 0.94 kg/m2 greater ( 95 % confidence interval [ CI ] , 0.35 to 1.52 ) than in their brothers born before their mother was diagnosed with diabetes , after adjustment for birth year , maternal age , parity and education , birth weight , gestational age , and age at assessment of BMI . Early-pregnancy BMI was positively associated with son 's BMI between nonsiblings , but there was no association within brothers . Adjustment of the maternal diabetes-offspring BMI association for maternal BMI did not alter the association either within brothers or between nonsiblings . Results were also robust to sensitivity analyses restricting the within-sibling analyses to siblings born within 3 years of each other . Conclusion — Maternal diabetes mellitus has long-term consequences for greater BMI in offspring ; this association is likely to be via intrauterine mechanisms , and is independent of maternal BMI in early pregnancy Please cite this paper as : Ijäs H , Vääräsmäki M , Morin‐Papunen L , Keravuo R , Ebeling T , Saarela T , Raudaskoski T. Metformin should be considered in the treatment of gestational diabetes : a prospect i ve r and omised study . BJOG 2011;118:880–885 OBJECTIVES To study glibenclamide as a treatment for gestational diabetes mellitus ( GDM ) and its impact on newborn birth weight and neonatal glycemia as compared to insulin . METHODS A r and omized and open-label clinical trial , conducted from October 1st , 2003 to March 8 , 2005 . Seventy-two pregnant women with gestational diabetes mellitus requiring drug therapy were r and omized and allocated into two groups -- insulin and glibenclamide . RESULTS The general characteristics in both groups were similar , except for the results of the 75 g OGTT , which were higher in the glibenclamide group ( p= 0.02 ) . Maternal fasting and postpr and ial glucose levels presented no difference . Six ( 18.75 % ) pregnant women received the maximum dose of glibenclamide with no glycemic control . The birth weight was higher in the group treated with glibenclamide ( p= 0.01 ) , and the incidence of macrosomic newborns statistically different ( p= 0.01 ) . Neonatal hypoglycemia was more frequent ( p= 0.01 ) in newborns of glibenclamide group , with one single case of persistent hypoglycemia . CONCLUSION Glibenclamide can be the first line drug for glycemic control in most GDM patients . The birth weight and incidence of hypoglycemia were higher in the glibenclamide group , but with one single case of persistent hypoglycemia that required intravenous infusion of glucose Aims /hypothesisNew diagnostic criteria for gestational diabetes mellitus ( GDM ) have recently been published . We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population . Methods The Atlantic Diabetes In Pregnancy ( DIP ) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24–28 weeks . GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups ( IADPSG ) criteria and compared with previous WHO criteria ; maternal and neonatal adverse outcomes were prospect ively recorded . Results 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We set out to reevaluate the hypothesis that high normal ( negative ) results of 50 g oral glucose challenge test or high normal glucose level on 100 g oral glucose tolerance test are associated with complications of pregnancy and delivery .  This was a prospect i ve study involving 735 nondiabetic women . The first group ( n=352 ) was made up of pregnant women with normal 50 g oral glucose challenge test without previous history of diabetes mellitus or gestational diabetes . The second group ( n=383 ) was made up of pregnant women without previous history of diabetes mellitus or gestational diabetes with an abnormal 50 g oral glucose challenge test and with normal 100 g oral glucose tolerance test and not more than one previous delivery . In nondiabetic women , we demonstrated a positive correlation between high normal 50 g glucose challenge test values and the incidence of preeclampsia , caesarean section rate , macrosomia , neonatal hyperlipidaemia and minor congenital abnormalities . We failed to confirm any relationship to any pregnancy complication in pregnant women with 2-hour glucose levels in the range 6.7 - 9.1 mmol/l on the 100 g oral glucose tolerance test . We have demonstrated a positive relationship between the incidence of premature rupture of membranes and 1-hour glucose level , caesarean section rate and maternal 1-hour glucose level or 1-hour glucose level minus fasting glucose level of 4.2 mmol/l , instrumental delivery rate and maternal 3-hour glucose level , incidence of neonatal macrosomia and 1-hour glucose level , and incidence of neonatal hyperlipidaemia and at least one high but normal glucose level on the 100 g oral glucose tolerance test . With regard to pregnancy and delivery complications there were no significant difference if the high normal value is on the 50 g glucose challenge test or on the 100 g oral glucose tolerance test . It is concluded that one high normal 100 g oral glucose tolerance test or high normal 50 g glucose challenge test are associated with adverse pregnancy and delivery outcome . Nondiabetic women with 50 g glucose challenge test value of 6.1 mmol/l and /or 100 g oral glucose tolerance test values of 5 mmol/l have a favourable pregnancy and delivery outcome OBJECTIVE —We investigated the effects of normal variations in maternal glycemia on birth size and other birth outcomes . RESEARCH DESIGN AND METHODS —Women in two unselected birth cohorts , one retrospective ( n = 3,158 ) and one prospect i ve ( n = 668 ) , underwent an oral glucose challenge at 28 weeks of gestation . In the retrospective study , glycemia was linked to routine birth records . In the prospect i ve study , offspring adiposity was assessed by skinfold thickness from birth to age 24 months . RESULTS —In the retrospective study , within the nondiabetic range ( 2.1–7.8 mmol/l ) , each 1 mmol/l rise in the mother 's 60-min glucose level was associated with a ( mean ± SEM ) 2.1 ± 0.8 % ( P = 0.006 ) rise in absolute risk of assisted vaginal delivery , a 3.4 ± 0.8 % ( P < 0.0001 ) rise in emergency cesarean delivery , a 3.1 ± 0.7 % ( P < 0.0001 ) rise in elective cesarean delivery , and a 46 ± 8 g ( P < 0.0001 ) increase in offspring birth weight . In the prospect i ve study , fetal macrosomia ( birth weight > 90th centile ) was independently related to the mother 's fasting glucose ( odds ratio 2.61 per + 1 mmol/l [ 95 % CI 1.15–5.93 ] ) and prepregnancy BMI ( 1.10 per + 1 kg/m2 [ 1.04–1.18 ] ) . The mother 's higher fasting glycemia ( P = 0.004 ) , lower insulin sensitivity ( P = 0.01 ) , and lower insulin secretion ( P = 0.02 ) were independently related to greater offspring adiposity at birth . During postnatal follow-up , the correlation between the mother 's glycemia and offspring adiposity disappeared by 3 months , whereas prepregnancy BMI was associated with offspring adiposity that was only apparent at 12 and 24 months ( both P < 0.05 ) . CONCLUSIONS —Prepregnancy BMI , pregnancy glycemia , insulin sensitivity , and insulin secretion all contribute to offspring adiposity and macrosomia and may be separate targets for intervention to optimize birth outcomes and later offspring health Aims /hypothesisTo determine the extent to which gestational fasting and postload levels of glucose explain differences in infant fat mass between UK-born Pakistani and white British infants . Methods Analyses were undertaken in a prospect i ve pregnancy cohort study of 1,415 women and their singleton live-born infants ( 629 white British and 786 Pakistani ) . Infant fat mass was assessed by cord-blood leptin levels and fetal insulin secretion by cord-blood insulin levels . Maternal OGTTs were completed at 26–28 weeks of gestation . Results Pakistani women had higher fasting and postload glucose levels and greater incidence of gestational diabetes than white British women .  Higher fasting and postload glucose levels were associated with higher cord-blood levels of insulin and leptin in all participants , irrespective of ethnicity . Cord-blood leptin levels were 16 % ( 95 % CI 6 , 26 ) higher in Pakistani than in white British infants . After adjustment for fasting glucose levels , this difference attenuated to 7 % ( −3 , 16 ) , and with additional adjustment for cord-blood insulin levels it attenuated further to 5 % ( −4 , 14 ) . Path analyses supported the hypothesis that fasting glucose levels mediate the relationship of Pakistani ethnicity to greater fat mass at birth , as measured by cord-blood leptin levels ; on average , 19 % of this mediation involved fetal insulin secretion . Postload glucose levels did not act as an important mediator of ethnic differences in cord-blood leptin levels . Results were very similar when 130 women with gestational diabetes were removed . Conclusions /interpretationThese novel findings suggest a role of maternal pregnancy glycaemia in mediating differences in fat mass between Pakistani and white British infants Aims /hypothesisGestational diabetes mellitus ( GDM ) is associated with increased risks to mother and child , but globally agreed diagnostic criteria remain elusive . Identification of women with GDM is important , as treatment reduces adverse outcomes such as perinatal death , shoulder dystocia and neonatal hypoglycaemia . Recently , the UK ’s National Institute for Health and Care Excellence ( NICE ) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups ( IADPSG ) criteria endorsed by the WHO . The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria . Methods Data from 25,543 consecutive singleton live births ( 2004–2008 ) were obtained retrospectively from hospital records . Women were screened with a r and om plasma glucose ( RPG ; 12–16 weeks ) and a 50 g glucose challenge test ( GCT ; 26–28 weeks ) . If RPG > 7.0 mmol/l , GCT > 7.7 mmol/l or symptoms were present , a 75 g OGTT was offered ( n = 3,848 ) . Results In this study , GDM prevalence was 4.13 % ( NICE 2015 ) and 4.62 % ( IADPSG ) . Women who ‘ fell through the net ’ , testing NICE-negative but IADPSG-positive ( n = 387 ) , had a higher risk of having a large-for-gestational-age ( LGA ) infant ( birthweight > 90th percentile for gestational age ; adjusted OR [ 95 % CI ] 3.12 [ 2.44 , 3.98 ] ) , Caesarean delivery ( 1.44 [ 1.15 , 1.81 ] ) and polyhydramnios ( 6.90 [ 3.94 , 12.08 ] ) compared with women with negative screening results and no OGTT ( n = 21,695 ) . LGA risk was highest among women with fasting plasma glucose 5.1–5.5 mmol/l ( n = 167 ) : the mean birthweight was 350 g above that of the reference population and 37.7 % of infants were LGA . Conclusions /interpretationThe IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria Background — Maternal diabetes mellitus in pregnancy results in greater  offspring adiposity  at birth . It is unclear whether it is associated with greater adiposity into adulthood , and if so , whether this is via intrauterine mechanisms or shared familial characteristics . Methods and Results — A record-linkage prospect i ve cohort study of 280 866 singleton-born Swedish men from 248 293 families was used to explore the intrauterine effect of maternal diabetes mellitus on offspring body mass index ( BMI ) in early adulthood . Maternal diabetes mellitus during pregnancy was associated with greater mean BMI at age 18 in their sons . The difference in BMI was similar within brothers and between nonsiblings . BMI of men whose mothers had diabetes mellitus during their pregnancy was on average 0.94 kg/m2 greater ( 95 % confidence interval [ CI ] , 0.35 to 1.52 ) than in their brothers born before their mother was diagnosed with diabetes , after adjustment for birth year , maternal age , parity and education , birth weight , gestational age , and age at assessment of BMI . Early-pregnancy BMI was positively associated with son 's BMI between nonsiblings , but there was no association within brothers . Adjustment of the maternal diabetes-offspring BMI association for maternal BMI did not alter the association either within brothers or between nonsiblings . Results were also robust to sensitivity analyses restricting the within-sibling analyses to siblings born within 3 years of each other . Conclusion — Maternal diabetes mellitus has long-term consequences for greater BMI in offspring ; this association is likely to be via intrauterine mechanisms , and is independent of maternal BMI in early pregnancy Please cite this paper as : Ijäs H , Vääräsmäki M , Morin‐Papunen L , Keravuo R , Ebeling T , Saarela T , Raudaskoski T. Metformin should be considered in the treatment of gestational diabetes : a prospect i ve r and omised study . BJOG 2011;118:880–885 OBJECTIVES To study glibenclamide as a treatment for gestational diabetes mellitus ( GDM ) and its impact on newborn birth weight and neonatal glycemia as compared to insulin . METHODS A r and omized and open-label clinical trial , conducted from October 1st , 2003 to March 8 , 2005 . Seventy-two pregnant women with gestational diabetes mellitus requiring drug therapy were r and omized and allocated into two groups -- insulin and glibenclamide . RESULTS The general characteristics in both groups were similar , except for the results of the 75 g OGTT , which were higher in the glibenclamide group ( p= 0.02 ) . Maternal fasting and postpr and ial glucose levels presented no difference . Six ( 18.75 % ) pregnant women received the maximum dose of glibenclamide with no glycemic control . The birth weight was higher in the group treated with glibenclamide ( p= 0.01 ) , and the incidence of macrosomic newborns statistically different ( p= 0.01 ) . Neonatal hypoglycemia was more frequent ( p= 0.01 ) in newborns of glibenclamide group , with one single case of persistent hypoglycemia . CONCLUSION Glibenclamide can be the first line drug for glycemic control in most GDM patients . The birth weight and incidence of hypoglycemia were higher in the glibenclamide group , but with one single case of persistent hypoglycemia that required intravenous infusion of glucose Aims /hypothesisNew diagnostic criteria for gestational diabetes mellitus ( GDM ) have recently been published . We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population . Methods The Atlantic Diabetes In Pregnancy ( DIP ) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24–28 weeks . GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups ( IADPSG ) criteria and compared with previous WHO criteria ; maternal and neonatal adverse outcomes were prospect ively recorded . Results 
    Output:
    