Maternal BMI, glucose tolerance, and adverse pregnancy outcomes

Stuebe, Alison M.; Landon, Mark B.; Lai, Yinglei; Spong, Catherine Y.; Carpenter, Marshall W.; Ramin, Susan M.; Casey, Brian M.; Wapner, Ronald J.; Varner, Michael W.; Rouse, Dwight J.; Sciscione, Anthony; Catalano, Patrick M.; Harper, Margaret; Saade, George R.; Sorokin, Yoram; Peaceman, Alan M.; Tolosa, Jorge E.

doi:10.1016/j.ajog.2012.04.035

Cited by 64 publications

(43 citation statements)

References 35 publications

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“…We also showed an increased risk of PIH in obese versus nonobese GDM mothers while those women managed by diet-only were more likely to have gestational hypertension. Previous researchers have consistently shown similar findings [16,[25][26][27][28][29][30][31][32]. Similar findings apply to increased prevalence of C-section in obese versus non-obese GDM mothers (50.6% vs.37.5%).…”

Section: Discussionsupporting

confidence: 76%

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

AT¹

2016

J Obes Weight Loss Ther

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We aimed to investigate the co-morbid effects of maternal obesity, Gestational Diabetes Mellitus (GDM), and GDM treatment options on maternal and neonatal outcomes in an inner-city population. This is a retrospective chart review study of singleton mothers with new diagnosis of GDM and their infants during a 3-year period. During the study period, 356 women ages 13-48 years with GDM gave birth to 180 males and 175 females. Majority of mothers were African American (50.8%) and had Medicaid insurance (75.8%). Obese mothers constituted 48.3% of the study population, had a higher prevalence of pregnancy induced hypertension/preeclampsia, more commonly were managed with medication and delivered by C-section than non-obese mothers. Infants of obese GDM mothers had significantly higher mean birth weight, lower mean blood glucose, and were less at risk for Small for Gestational Age (SGA). In obese mothers, heaviest mothers had infants with higher bilirubin levels than less heavy mothers. We also observed a high rate of feeding difficulty in infants of GDM mothers (12.4%). Our study emphasizes the burden of maternal obesity as a major risk factor for both maternal and neonatal poor outcomes in the context of GDM and calls for further prospective and interventional research.

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Section: Discussionsupporting

confidence: 76%

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

AT¹

2016

J Obes Weight Loss Ther

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“…As a potential explanation of the etiology of complications due to maternal obesity, a role of endothelial dysfunction in the systemic and/or peripheral vasculatures has been hypothesized [11,13,14].…”

Section: Introductionmentioning

confidence: 99%

“…Maternal obesity is a well-known risk factor of various morbidities in-utero [11][12][13]; and, it can therefore be inferred that mothers with abnormal body mass index (BMI) are at increased risk of developing obstetric complications such as pregnancy-induced hypertension, gestational diabetes, cesarean delivery, and stillbirth [13,14]. As a potential explanation of the etiology of complications due to maternal obesity, a role of endothelial dysfunction in the systemic and/or peripheral vasculatures has been hypothesized [11,13,14].…”

Section: Introductionmentioning

confidence: 99%

The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity

Kim

Lee

Shin

et al. 2015

Obesity Research & Clinical Practice

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“…The premise for GDM treatment is, in part, based on the assumption of a positive independent relationship between maternal glycaemia and neonatal adiposity (Catalano et al, 2003;Stuebe et al, 2012;Aris et al, 2014). The Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study revealed strong, predominantly linear associations between maternal glycaemia and birthweight 490th percentile, per cent body fat (BF%) 490th percentile, pre-eclampsia, caesarean childbirth, shoulder dystocia and clinical neonatal hypoglycaemia (HAPO, 2008(HAPO, , 2009).…”

Section: Introductionmentioning

confidence: 99%

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Raynes‐Greenow

Turner

et al. 2016

Midwifery

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a b s t r a c tObjective: Pregnancies complicated with gestational diabetes mellitus (GDM) are at a higher risk for caesarean and instrumental deliveries as well as adverse neonatal outcomes such as fetal overgrowth, hypoglycaemia and neonatal intensive care admission. Our primary objective was to describe neonatal outcomes in a sample that included term infants of both GDM mothers and mothers with normal glucose tolerance (NGT). Design and setting: this cross-sectional study included 599 term babies born between September and October 2010 at Royal Prince Alfred Hospital, Sydney, Australia. Maternal and neonatal data were collected from medical records and a questionnaire. Glycaemic control data was based on third trimester HbA1c levels and self-monitoring blood glucose levels (BGL). Univariate associations between GDM status and maternal demographic factors, as well as pregnancy outcomes, were estimated using χ 2 tests and t-tests, as appropriate. Findings: of 599 babies, 67(11%) were born to GDM mothers. GDM mothers were more likely to be overweight/obese and of Asian ethnicity. Good glycaemic control was achieved in most GDM mothers. GDM babies were more likely to have been induced (p ¼0.013) and delivered earlier than non-GDM mothers (p o0.001), and they were also more likely to be breastfed within one hour of birth. Conclusions and implications for practice: in this study, GDM infants were more likely to be induced and delivered earlier but otherwise they did not have significantly different neonatal outcomes compared to infants of NGT mothers. This can be attributed to the good GDM control by lifestyle modification and insulin if necessary. The role of labour induction in GDM pregnancies should be further investigated. Midwives have an important role in maternal education during pregnancy and in the postnatal period.

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Maternal BMI, glucose tolerance, and adverse pregnancy outcomes

Cited by 64 publications

References 35 publications

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

The predictive value of the uterine artery pulsatility index during the early third trimester for the occurrence of adverse pregnancy outcomes depending on the maternal obesity

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

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