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Comment & Response
October 2015

Glyburide vs Insulin and Adverse Pregnancy Outcomes—Reply

Author Affiliations
  • 1Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore
  • 2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
JAMA Pediatr. 2015;169(10):975. doi:10.1001/jamapediatrics.2015.1811

In Reply We thank Feghali et al and Rezai et al for their interest in our article.1 They raise important considerations when interpreting our results. We acknowledge that our measure for obesity is imperfect and that there is the potential for residual confounding. Previous literature has shown that neonatal risk increases gradually with higher maternal weight, and this may also be the case among pharmacologically treated women.2 In light of the inherent heterogeneity among women initiating pharmacological treatment, we need to better understand whether the increased risk for women treated with glyburide (compared with insulin) varies by maternal weight.