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

Machado, Catarina; Monteiro, Sara; Oliveira, Maria João

doi:10.20945/2359-3997000000178

Cited by 9 publications

(12 citation statements)

References 29 publications

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“…Moreover, the finding in our study on association between underweight and LBW was also in line with previous literature (Li et al, 2013;Liu et al, 2012). Previous literature has revealed that maternal overweight and obesity were associated with the increased risk for gestational hypertension and caesarian delivery (Lewandowska, Wieckowska & Sajdak, 2020;Machado, Monteiro & Oliveira, 2020;Vince et al, 2020). Our study also confirmed these findings.…”

Section: Discussionsupporting

confidence: 93%

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Association of pre-pregnancy body mass index with adverse pregnancy outcome among first-time mothers

Chen

Lin

et al. 2020

PeerJ

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Background Studies have reported an increased risk of adverse pregnancy outcome associated with pre-pregnancy body mass index (BMI). However, the data on such associations in urban areas of southern Chinese women is limited, which drive us to clarify the associations of pre-pregnancy BMI and the risks of adverse pregnancy outcomes (preterm birth (PTB) and low birth weight (LBW)) and maternal health outcomes (gestational hypertension and cesarean delivery). Methods We performed a hospital-based case-control study including 3,864 Southern Chinese women who gave first birth to a live singleton infant from January 2015 to December 2015. PTB was stratified into three subgroups according to gestational age (extremely PTB, very PTB and moderate PTB). Besides, we combined birth weight and gestational age to dichotomise as being small for gestational age (SGA, less than the tenth percentile of weight for gestation) and non-small for gestational age (NSGA, large than the tenth percentile of weight for gestation), gestational week was also classified into categories of term, 34-36 week and below 34 week.. We then divided newborns into six groups: (1) term and NSGA; (2) 34–36 week gestation and NSGA; (3) below 34 week gestation and NSGA; (4) term and SAG; (5) 34–36 week gestation and SAG; (6) below 34 week gestation and SAG. Adjusted logistic regression models was used to estimate the odds ratios of adverse outcomes. Results Underweight women were more likely to give LBW (AOR = 1.44, 95% CI [1.11–1.89]), the similar result was seen in term and SAG as compared with term and NSAG (AOR = 1.78, 95% CI [1.45–2.17]), whereas underweight was significantly associated with a lower risk of gestational hypertension (AOR = 0.45, 95% CI [0.25–0.82) and caesarean delivery (AOR = 0.74, 95% CI [0.62–0.90]). The risk of extremely PTB is relatively higher among overweight and obese mothers in a subgroup analysis of PTB (AOR = 8.12, 95% CI [1.11–59.44]; AOR = 15.06, 95% CI [1.32–172.13], respectively). Both maternal overweight and obesity were associated with a greater risk of gestational hypertension (AOR = 1.71, 95% CI [1.06–2.77]; AOR = 5.54, 95% CI [3.02–10.17], respectively) and caesarean delivery (AOR = 1.91, 95% CI [1.53–2.38]; AOR = 1.85, 95% CI [1.21–2.82], respectively). Conclusions Our study suggested that maternal overweight and obesity were associated with a significantly higher risk of gestational hypertension, caesarean delivery and extremely PTB. Underweight was correlated with an increased risk of LBW and conferred a protective effect regarding the risk for gestational hypertension and caesarean delivery for the first-time mothers among Southern Chinese.

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Section: Discussionsupporting

confidence: 93%

“…Previous literature has revealed that maternal overweight and obesity were associated with the increased risk for gestational hypertension and caesarian delivery ( Lewandowska, Wieckowska & Sajdak, 2020 ; Machado, Monteiro & Oliveira, 2020 ; Vince et al, 2020 ). Our study also confirmed these findings.…”

Section: Discussionmentioning

confidence: 99%

Association of pre-pregnancy body mass index with adverse pregnancy outcome among first-time mothers

Chen

Lin

et al. 2020

PeerJ

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“…the prevalence of overweight and inactivity and dietary changes (4)(5)(6). In the HAPO study, blood glucose levels in the 75-g OGTT before and 1 and 2 h after glucose intake were independently associated with maternal and perinatal complications (2).…”

mentioning

confidence: 99%

A comparison of meal tolerance test and oral glucose tolerance test for predicting insulin therapy in patients with gestational diabetes

Hijikata

Higa²,

Ichijo³

et al. 2021

Food & Nutrition Research

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Aims: To identify factors predicting a need for insulin therapy in gestational diabetes mellitus (GDM) by comparing plasma glucose (PG) levels in a 75-g oral glucose tolerance test (75-g OGTT) with those in a 500-kcal meal tolerance test (MTT) containing 75 g of carbohydrate. Subjects and methods: The MTT was performed in 61 patients who diagnosed with GDM by a 75-g OGTT (age, 33.2 ± 4.5 years; prepregnancy body mass index, 22.6 ± 4.7 kg/m2; number of gestational weeks, 25.1 ± 6.4 weeks). PG and serum insulin levels were measured before the meal and up to 180 min after the meal. The insulin secretion capacity and resistance index were calculated. Results: PG levels increased from 86.8 ± 8.8 mg/dL at fasting to 132.7 ± 20.1 mg/dL at 30 min, and 137.8 ± 27.7 mg/dL at 60 min after MTT in the 35 patients with needed insulin therapy; these levels were significantly higher than those in the 26 patients, who only needed diet therapy. The patients with needed insulin therapy had significantly higher fasting PG levels in the 75-g OGTT, PG levels at fasting and 30 min after the MTT, and homeostasis model assessment of insulin resistance (HOMA-IR), and a significantly lower disposition index (DI) and insulin index than patients treated by diet alone. Receiver operating characteristic curve analysis was performed for factors involved in insulin therapy, with the following cutoff values: fasting PG in the 75-g OGTT, 92 mg/dL; PG 30 min after MTT, 129 mg/dL; HOMA-IR, 1.51; DI, 3.9; HbA1c, 5.4%. Multivariate analysis revealed that the 30-min PG level after MTT and HOMA-IR predicted insulin therapy. Conclusion: PG levels at 30 min after MTT may be useful for identifying patients with GDM, who need insulin therapy.

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“…Pesquisas nacionais e internacionais com DMG, identificaram excesso de peso em período pré-gestacional, com variação de 47,8% a 74% (Guerra et al, 2018;Larrabure-Torrealva et al, 2018;Machado et al, 2019;Tavares et al, 2019).…”

Section: Resultsunclassified

“…Em relação ao ganho ponderal excessivo, a literatura mostra variação de 26,1% a 35,4%, com maiores valores em mulheres com sobrepeso e obesidade pré-gestacional (36,7% e 36,9%) respectivamente. Ao mesmo tempo que gestantes de baixo peso (48,3%) e eutróficas (50,2%), podem apresentar ganho ponderal abaixo do recomendado (Machado et al, 2019;Tavares et al, 2019). Ademais foi observada associação estatística significante entre o ganho ponderal e o estado nutricional prévio no estudo de Machado et al (2019); fato não observado no presente estudo.…”

Section: Resultsunclassified

Ganho ponderal e estado nutricional de mulheres portadoras de diabetes mellitus gestacional

Neris

Silva

Albuquerque

et al. 2021

RSD

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Objetivo: Analisar o ganho ponderal e o estado nutricional de gestantes portadoras de diabetes mellitus gestacional. Metodologia: Trata-se de um estudo de caráter descritivo, com corte transversal, realizado entre agosto a dezembro de 2020, em serviço de referência de gestação de alto risco de Pernambuco. Foram estudadas variáveis antropométricas, sociodemográficas, clínicas, obstétricas e de estilo de vida. Para análise estatística foram utilizados os testes Qui-Quadrado de Pearson e Exato de fisher, quando aplicável, com nível de significância de 5%. Resultados: Foram avaliadas 101 gestantes com idade de 30,73 ± 6,29 anos, a maioria (79,2%) com excesso de peso prévio e com elevação durante a gestação (85,1%). O ganho ponderal acima do recomendado foi predominante (45,3%), revelando associação positiva com o estado nutricional atual. A presença de patologias associadas ao DMG foi a única variável obstétrica, que apresentou associação significativa com o estado nutricional prévio, atual e ganho ponderal gestacional, independente do tipo de comorbidades. Conclusão: O ganho ponderal acima do recomendado foi predominante, assim como a frequência de excesso de peso antes e durante a gestação, o que evidencia a importância do acompanhamento nutricional em portadoras de diabetes mellitus gestacional.

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

Cited by 9 publications

References 29 publications

Association of pre-pregnancy body mass index with adverse pregnancy outcome among first-time mothers

Association of pre-pregnancy body mass index with adverse pregnancy outcome among first-time mothers

A comparison of meal tolerance test and oral glucose tolerance test for predicting insulin therapy in patients with gestational diabetes

Ganho ponderal e estado nutricional de mulheres portadoras de diabetes mellitus gestacional

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