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Poster Session II Thursday, February 14 • 4:00 PM - 5:30 PM • Octavius Ballroom • Caesars Palace| Volume 220, ISSUE 1, SUPPLEMENT , S273, January 01, 2019

401: Pregnancy outcomes with telemedicine management in women with gestational diabetes mellitus

      Objective

      Telemedicine care is an innovative healthcare delivery approach to help overcome difficulties with access to care. We sought to compare pregnancy outcomes with in-person and telemedicine Maternal-Fetal Medicine consultation in women with gestational diabetes mellitus (GDM).

      Study Design

      This is a retrospective cohort study of 542 pregnant women with GDM who underwent Maternal-Fetal Medicine consultation between 2016 and 2017. GDM management included physician consultation, medical nutrition therapy counseling by a certified diabetes educator, and weekly glycemic surveillance for both telemedicine and in-person groups. We compared baseline maternal characteristics and pregnancy outcomes based on the type of care.

      Results

      Telemedicine management was performed in 88 (16%) of women with GDM. Women undergoing telemedicine management were younger (29.6 vs 32.2, p<0.001), more likely to be obese (71.6 vs 55%, p=0.02), and to actively smoke (22.7 vs 11.1, p=0.01), but there were no differences in gestational age at GDM diagnosis (23.7 vs 25.1 weeks, p=0.06). Need for pharmacologic therapy was similar in both groups (53.4 vs. 54.8%, p=0.8). Also, mean fasting (100.5 vs 98.7 mg/dL, p=0.4) and postprandial (130.8 vs 129.9 mg/dL, p=0.7) glucose values were similar in women undergoing telemedicine and in-person consultation. Pregnancy outcomes did not differ by management type including preterm birth, hypertensive disorders of pregnancy and cesarean delivery. Neonatal outcomes were similar including NICU admission (17.1 vs. 25.2%, p=0.1) and composite neonatal morbidity (52.3 vs. 45.2%, p=0.2) in women with GDM undergoing telemedicine and in-person management.

      Conclusion

      We found no difference in pregnancy outcomes in women with GDM who underwent telemedicine or in-person management. Our findings suggest a potential role for telemedicine care in the management of women with GDM.