Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children’s study

Yasuda

Murata

et al. 2021

J of Diabetes Invest

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Aims/Introduction To examine adverse outcomes in women with early‐diagnosed gestational diabetes mellitus using data from a large birth cohort study in Japan. Materials and Methods This study analyzed data from singleton pregnancies in the Japan Environment and Children’s Study including births during 2011–2014. Mothers with an HbA1c level ≥6.5% in the first trimester, a history of diabetes mellitus, or steroid use during pregnancy were excluded. The participants were divided into three groups: control (without gestational diabetes mellitus), early‐diagnosed gestational diabetes mellitus (diagnosed before gestational week 24), and late‐diagnosed gestational diabetes mellitus (diagnosed after gestational week 24). Multiple logistic regression analysis was performed to calculate the risk of early‐diagnosed and late‐diagnosed gestational diabetes mellitus for adverse obstetrics outcomes. Results In total, 100,376 eligible participants were included in this study. The number of individuals in control cases, early‐diagnosed gestational diabetes mellitus cases, and late‐diagnosed gestational diabetes mellitus cases was 98,090 (97.7%), 751 (0.7%), and 1,535 (1.5%), respectively. When control cases were used as reference, multiple logistic regression analysis revealed that early‐diagnosed gestational diabetes mellitus increased the risk of hypertensive disorders of pregnancy (adjusted odds ratio: 2.08, 95% confidence interval: 1.51–2.86), early‐onset hypertensive disorders of pregnancy (adjusted odds ratio: 1.91, 95% confidence interval: 1.01–3.65), and late‐onset hypertensive disorders of pregnancy (adjusted odds ratio: 1.92, 95% confidence interval: 1.29–2.86). Conclusion Early‐diagnosed gestational diabetes mellitus is associated with serious obstetric complications. Our findings indicate the necessity of further investigations to validate the benefit of early screening for gestational diabetes mellitus in pregnant women.

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Adverse obstetric outcomes in early‐diagnosed gestational diabetes mellitus: The Japan Environment and Children’s Study

Yasuda

Murata

et al. 2021

J of Diabetes Invest

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“…Obstetric outcomes included PTB, low birthweight, small for gestational age, HDP, and GDM. PTB, low birthweight, and small for gestational age were defined as delivery <37 weeks, birthweight of the neonate <2500 g, and birthweight <−1.5 SDs below the population mean, corrected for gestational age and sex according to the “New Japanese neonatal anthropometric charts for gestational age at birth, respectively.” 16,18 HDP was defined as new onset of hypertension (≥140/90 mmHg) after conception 19 and classified into two categories: early‐onset and late‐onset HDP (HDP onset before and after 34 weeks of gestation, respectively). All pregnant women participating in the present study underwent the universal two‐step screening process used as standard practice in Japan for the diagnosis of GDM both in early and late pregnancy 20,21 .…”

Section: Methodsmentioning

confidence: 99%

Age at menarche and risk of adverse obstetric outcomes during the first childbirth in Japan: The Japan Environment and Children's Study

Kanno

J of Obstet and Gynaecol

Murata

et al. 2021

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Aim Age at menarche is used as a risk indicator of gestational diabetes mellitus, preterm birth, and fetal growth. However, little is known regarding the age impact on obstetric outcomes among nulliparous women. This study investigated whether menarche age was correlated with obstetric outcomes among nulliparous women. Methods We analyzed the data obtained for 37 645 singleton pregnancies between 2011 and 2014 in the Japan Environment and Children's Study. Age at menarche was categorized into the ≤9‐, 10‐, 11‐, 12‐, 13‐, 14‐, and ≥15‐year‐old groups (n = 363, 3155, 8390, 11 164, 6713, 5446, and 2414, respectively). We calculated the relative risk for cases of preterm birth <37 weeks, low birthweight <2500 g, small for gestational age, early and late‐onset hypertension disorders of pregnancy, and early‐ and late‐diagnosed (diagnosed < or ≧ 24 weeks) gestational diabetes mellitus using a reference of 12 years at menarche. Results Women with an age at menarche ≤9 years showed an increased incidence of developing early‐diagnosed gestational diabetes mellitus (relative risk: 2.42; 95% confidence interval: 1.05–5.60). A high body mass index before pregnancy increased the risk of developing gestational diabetes mellitus. Conclusions Age at menarche helped in assessing the risk of early‐diagnosed gestational diabetes mellitus among nulliparous women. Future studies are needed to clarify the underlying mechanisms. This study is the first to use data from the largest prospective birth cohort study of Japan and to investigate the relationship between menarche age and obstetric outcomes among nulliparous women.

“…Notwithstanding, the present study had potential limitations. First, although we accounted for several confounding factors, nutritional status during pregnancy, which is also an essential factor in preconception care, 33 and nutritional status before and during pregnancy, which usually affects weight gain and placental size, 34 were not considered in the present analysis. Therefore, further studies that account for maternal nutrition status both before and during pregnancy are required.…”

Section: Discussionmentioning

confidence: 99%

Effect of gestational weight gain on placental weight: A single tertiary referral center study of Japanese women

Jin

J of Obstet and Gynaecol

Fukuda

et al. 2021

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AimThe effect of gestational weight gain on placental weight has not been elucidated. We aimed to examine the effect of body weight gain during pregnancy on the Japanese standardized z‐score of placental weight, based on the pre‐pregnancy body mass index.MethodsThis retrospective cohort study included Japanese women with singleton pregnancies who gave birth during 2013–2019 at Ohta Nishinouchi Hospital. Participants (n = 3610) were categorized by their pre‐pregnancy body mass index: G1 (<18.5 kg/m2), G2 (18.5 to <20.0 kg/m2), G3 (20.0 to <23.0 kg/m2), G4 (23.0 to <25.0 kg/m2), and G5 (≥25.0 kg/m2). Multiple linear regression analysis was used to identify associations between insufficient or excessive gestational weight gain in each body mass index category and z‐score of placental weight, with adjustments for maternal age, assisted reproductive technology, and maternal pre‐pregnancy conditions, such as hypertension, diabetes mellitus, myoma uteri, and uterine anomalies.ResultsAmong the 3610 women assessed, 479, 692, 1292, 435, and 711 were in G1–G5, respectively. In G1, G3, and G4, excessive weight gain increased the placental weight z‐score ([B: 0.50, 95% confidence interval [CI]: 0.23–0.76], [B: 0.19, 95% CI: 0.19–0.33], and [B: 0.18, 95% CI: 0.10–0.26]). Insufficient weight gain decreased the placental weight z‐score in G3 (B: −0.19, 95% CI: −0.33 to −0.06) and G4 (B: −0.21, 95% CI: −0.29 to −0.13) women.ConclusionThe effect of weight gain during pregnancy on placental size varies by pre‐pregnancy body mass index. This result may guide personalized pre‐conception counseling to improve the outcomes of offspring.