whom labor is induced at 38 weeks and those for
whom labor is not induced. Moreover, it has also
been reported that there is no difference in the
incidence of macrosomia or caesarean section
between insulin-treated GDM patients for whom
labor is induced at 38–39 weeks and insulintreated GDM patients who electively waited for
labor and childbirth to take their natural course.
Although in general the rate of caesarean section
for GDM patients is high, there are some reports
that this is due to the concern of physicians about
shoulder dystocia occurring as the result of macrosomia, which has a high rate of frequency
amongst GDM patients. However, much of the
data is from the United States, and the average
birth weight of infants born in the United States
is higher than that in Japan. Thus it is thought
to be impossible to use overseas data as the Japanese standard from the standpoint of infant birth
weights