Obesity in patients with gestational diabetes: Impact on newborn outcomes

Abstract

ObjectiveTo compare the perinatal adverse outcomes of obese and non-obese pregnant women with Gestational Diabetes Mellitus (GDM). Materials and methodsThis is a Cross-sectional study. Data were collected from the medical records of patients diagnosed with GDM at Unimed Hospital Center in the city of Joinville, from 2011 to 2017. Maternal-fetal characteristics, therapies and complications of pregnant women diagnosed with GDM were analyzed. The subjects of the study were separated into two groups: obese and non-obese GDM patients. Statistical analysis was performed by calculating multinomial logistic regression, adjusted using the 95% confidence interval (CI). ResultsA total of 442 patients were described as having gestational diabetes, of which 260 (58.8%) were diagnosed with obesity and 182 (41.1%) were non-obese. Maternal characteristics diverged regarding the Body Mass Index (BMI) (30.0vs22.5 P = 0.000), Gestational Age (GA) from GDM diagnosis (26.95vs29.07 P = 0.002), cesarean section (c-section) (86.2%vs75.9% P = 0.003), the incidence of chronic Hypertension (10.3%vs4.2% P = 0.011), treatment by dieting (29.0%vs48.1% P = 0.000) and metformin (44.5%vs34.7% P = 0.027) of obese and non-obese pregnant women, respectively. As for newborns, there was a reduction in weight (3185.8vs3,217.4 P = 0.045) and in the number of newborns of normal weight (13.8%vs23.6% P = 0.005), of newborns from obese and non-obese mothers, respectively. After ratio calculation, it was noticed that obese pregnant women had a higher chance of undergoing a c-section (OR 2.137 CI 95%, 1257-3.631). There was no significance found in other pregnancy outcomes. ConclusionPregnant women diagnosed with GDM and obesity are approximately twice as likely to undergo Cesarean Surgery, compared to non-obese women. As a result, newborns will have a greater influence on the outcomes and occasional events of cesarean section.