Impact of overweight and obesity on pregnancy outcomes in women with gestational diabetes - results from a retrospective multicenter study.

Catarina Machado,Sara Monteiro,Maria João Oliveira

doi:10.20945/2359-3997000000178

Catarina Machado, Sara Monteiro + Show 1 more

Open Access

https://doi.org/10.20945/2359-3997000000178

Copy DOI

Abstract

Objective The aim of this study was to evaluate the impact of pre-pregnancy body mass index (BMI) on pregnancy outcomes in women with gestational diabetes (GD). Subjects and methods Retrospective multicenter study using data from the Portuguese National Register. We included women with GD with a singleton pregnancy. GD diagnosis was according to the International Association of the Diabetes and Pregnancy Study Group criteria. Women were divided into groups according to their pre-pregnancy BMI: < 18.5 kg/m2 (underweight), ≥ 18.5 and < 25.0 kg/m2 (normal weight), ≥ 25 and < 30 kg/m2 (overweight) and ≥ 30 kg/m2 (obese). Results We included 3,103 pregnant women with GD, 29.6% (n = 918) were overweight and 27.3% (n = 846) were obese. Compared to normal weight, the overweight and obese groups had a higher percentage of gestational hypertension (4.0% and 8.5% vs. 2.1%), cesarean delivery (32.8% and 41.3% vs. 27.9%), macrosomia (3.9% and 6.7% vs. 2.4%), and large for gestational age (LGA) newborns (8.3% and 13.5% vs. 6.0%). Obesity increased the risk of gestational hypertension (OR 4.5, p < 0.001), preeclampsia (OR 1.9, p = 0.034), cesarean delivery (OR 2.0, p < 0.001), macrosomia (OR 3.1, p < 0.001) and LGA (OR 2.3, p < 0.001). Conclusion In pregnant women with GD, pregnancy complications increase with pre-pregnancy BMI. In obese women, appropriate diet and counseling prior to gestation and more aggressive medical intervention during pregnancy are needed in order to prevent macrosomic and LGA newborns and to reduce maternal complications.

Highlights

Gestational diabetes (GD) is a term used to describe the presence of glucose intolerance with onset or first detected during pregnancy [1]
A 75-g 2-hour oral glucose tolerance test (OGTT) was performed in all women with normal first trimester fasting blood glucose levels (FBG), between 24-28 weeks of gestation, with OGTT thresholds according to the International Association for Diabetes in Pregnancy Study Group’s (IADPSG) [17]: fasting glucose ≥ 92mg/dL, 1-hour ≥ 180mg/dL and 2-hour ≥ 153 mg/dL
Obesity and gestational diabetes (GD) can lead to adverse outcomes, and, in our study, women who were overweight and obese prior to gestation had an increased risk of adverse pregnancy outcomes

Summary

Introduction

Gestational diabetes (GD) is a term used to describe the presence of glucose intolerance with onset or first detected during pregnancy [1]. The overweight and obese groups had a higher percentage of gestational hypertension (4.0% and 8.5% vs 2.1%), cesarean delivery (32.8% and 41.3% vs 27.9%), macrosomia (3.9% and 6.7% vs 2.4%), and large for gestational age (LGA) newborns (8.3% and 13.5% vs 6.0%).

Results

Conclusion