Abstract
The objective of the present study was to compare 24-hour glycemic levels between obese pregnant women with normal glucose tolerance and non-obese pregnant women. In the present observational, longitudinal study, continuous glucose monitoring was performed in obese pregnant women with normal oral glucose tolerance test with 75 g of glucose between the 24th and the 28th gestational weeks. The control group (CG) consisted of pregnant women with normal weight who were selected by matching the maternal age and parity with the same characteristics of the obese group (OG). Glucose measurements were obtained during 72 hours. Both the groups were balanced in terms of baseline characteristics (age: 33.5 [28.7-36.0] vs. 32.0 [26.0-34.5] years, p = 0.5 and length of pregnancy: 25.0 [24.0-25.0] vs. 25.5 [24.0-28.0] weeks, p = 0.6 in the CG and in the OG, respectively). Pre-breakfast glycemic levels were 77.77 ± 10.55 mg/dL in the CG and 82.02 ± 11.06 mg/dL in the OG (p<0.01). Glycemic levels at 2 hours after breakfast were 87.31 ± 13.10 mg/dL in the CG and 93.48 ± 18.74 mg/dL in the OG (p<0.001). Daytime blood glucose levels were 87.6 ± 15.4 vs. 93.1 ± 18.3 mg/dL (p<0.001) and nighttime blood glucose levels were 79.3 ± 15.8 vs. 84.7 ± 16.3 mg/dL (p<0.001) in the CG and in the OG, respectively. The 24-hour, daytime, and nighttime values of the area under the curve were higher in the OG when compared with the CG (85.1 ± 0.16 vs. 87.9 ± 0.12, 65.6 ± 0.14 vs. 67.5 ± 0.10, 19.5 ± 0.07 vs. 20.4 ± 0.05, respectively; p<0.001). The results of the present study showed that obesity in pregnancy was associated with higher glycemic levels even in the presence of normal findings on glucose tolerance test.
Highlights
During the last four decades, prevalence of obesity has increased dramatically around the world
Both the groups were balanced in terms of baseline characteristics
The 24-hour, daytime, and nighttime values of the area under the curve were higher in the obese group (OG) when compared
Summary
During the last four decades, prevalence of obesity has increased dramatically around the world. In 2016, the World Health Organization (WHO) estimated that approximately 650 million adults were obese, representing approximately 13% of the world’s adult population. The association of obesity with pregnancy has been an important public health problem and a major challenge for the professional team responsible for assisting this population. Maternal obesity is associated with adverse pregnancy and perinatal outcomes and long-term complications related to maternal and fetal health [3]. IR and dysfunctional beta-pancreatic cells are the main factors causing hyperglycemia [6, 7]. In this context, maternal obesity causes imbalance in glycemic homeostasis during pregnancy, resulting in an increased risk of GDM [8]
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