Obesity or diabetes: what is worse for the mother and for the baby?

Bo, Simona; Menato, Guido; Signorile, Anna; Bardelli, C; Lezo, Antonela; Gallo, ML; Gambino, Roberto; Cassader, Maurizio; Massobrio, M; Pagano, Gianfranco

doi:10.1016/s1262-3636(07)70026-5

Cited by 51 publications

(41 citation statements)

References 10 publications

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“…Physiological differences in glucose metabolism and/or fat storage may account for some of these differences and further research to understand these differences may help elucidate the underlying pathology of GDM and related metabolic impairments. The association of GDM, maternal obesity before pregnancy and weight gain during pregnancy with excess fetal growth has been widely studied individually [6,[14][15][16]. As each of these risk factors often occur in conjunction with the others, it is important to evaluate the association of each factor in the context of the two other major risk factors for excess fetal growth.…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: variations by race/ethnicity

et al. 2013

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Aims/hypothesis The escalating rate of childhood obesity is a public health concern worldwide, with children in certain ethnic groups being disproportionately affected. Our objective was to examine the joint effects of pre-pregnancy adiposity, pregnancy weight gain and gestational diabetes (GDM) in relation to excess fetal growth and to identify susceptible races or ethnic populations. Methods The risk for delivery of a large-for-gestational-age (LGA) infant, specific to race and fetal sex, was evaluated in 105,985 pregnancies in the Consortium on Safe Labor from [2002][2003][2004][2005][2006][2007][2008]. Generalised estimating equations were used to estimate the risk for delivery of LGA infants. Joint effects were employed to evaluate the interplay of three risk factors.Models were stratified by racial group considering one, two or three factors (i.e. pre-pregnancy adiposity, pregnancy weight gain and GDM, with 0 factors as the reference group). Results Greater pre-pregnancy adiposity, pregnancy weight gain and GDM were independently associated with increased risk of giving birth to an LGA infant across all races (except GDM among non-Hispanic whites), in both underweight and normal-weight women. Among non-Hispanic white, non-Hispanic black and Hispanic women, the threefactor joint effect was associated with substantially increased odds of LGA (OR [95% CI] 11. 27 [8.40, 15.11], 7.09 [4.81, 10.45] and 10.19 [6.84, 15.19], respectively). However, for Asian women the joint effect of all three factors (OR [95% CI] 5.14 [2.11, 12.50]) was approximately the same as any of the two factors. Conclusions/interpretation GDM, pre-pregnancy obesity and excessive pregnancy weight gain were jointly associated with elevated risk of giving birth to an LGA infant and the effects varied by race. This suggests that those involved in public health efforts aimed at preventing LGA deliveries should consider variations in racial groups when devising effective strategies.

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Section: Discussionmentioning

confidence: 99%

Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: variations by race/ethnicity

et al. 2013

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“…However, few studies have attempted to discern the relative influences of overweight and GDM [22][23][24][25][26][27]. Obesity and hyperglycaemia have been reported to be independent predictors of different obstetric and perinatal complications, but obesity was a stronger risk factor for macrosomia, Caesarean section and hypertension than hyperglycaemia [24][25][26][27]. Glucose tolerance status, and especially obesity, acted in a dose-dependent manner, increasing the risk of perinatal complications as glucose intolerance and BMI increased.…”

Section: Discussionmentioning

confidence: 99%

Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia

et al. 2005

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Aims/hypothesis: We evaluated diabetes-related pregnancy outcomes in a cohort of Spanish women in relation to their glucose tolerance status, prepregnancy BMI and other predictive variables. Methods: The present paper is part of a prospective study to evaluate the impact of American Diabetes Association (2000) criteria in the Spanish population. A total of 9,270 pregnant women were studied and categorised as follows according to prepregnancy BMI quartiles and glucose tolerance status: (1) negative screenees; (2) false-positive screenees; (3) gestational diabetes mellitus (GDM) according to American Diabetes Association criteria only; and (4) GDM according to National Diabetes Data Group criteria (NDDG). We evaluated fetal macrosomia, Caesarean section and seven secondary outcomes as diabetes-related pregnancy outcomes. The population-attributable and population-prevented fractions of predictor variables were calculated after binary logistic regression analysis with multiple predictors. Results: Both prepregnancy BMI and abnormal glucose tolerance categories were independent predictors of pregnancy outcomes. The upper quartile of BMI accounted for 23% of macrosomia, 9.4% of Caesarean section, 50% of pregnancy-induced hypertension and 17.6% of large-for-gestational-age newborns. In contrast, NDDG GDM accounted for 3.8% of macrosomia, 9.1% of pregnancy-induced hypertension and 3.4% of preterm births. Conclusions/ interpretation: In terms of population impact, prepregnancy maternal BMI exhibits a much stronger influence than abnormal blood glucose tolerance on macrosomia, Caesarean section, pregnancy-induced hypertension and large-for-gestational-age newborns.

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“…19 Bo et al had observed that increased blood glucose in pregnancy was a risk factor for higher gestational weight gain. 20 There is misbelief that over nourishment during pregnancy is essential and hesitancy among pregnant women to do even simple household works due to fear of losing baby, along with lack of exercise and improper diet control plays an important role.…”

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confidence: 99%

Prevalence of gestational diabetes mellitus in antenatal women and its associated risk factors

Gracelyn

Saranya

2016

Int J Reprod Contracept Obstet Gynecol

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Obesity or diabetes: what is worse for the mother and for the baby?

Cited by 51 publications

References 10 publications

Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: variations by race/ethnicity

Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: variations by race/ethnicity

Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia

Prevalence of gestational diabetes mellitus in antenatal women and its associated risk factors

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