Pre-pregnancy overweight or obesity and gestational diabetes as predictors of body composition in offspring twenty years later: evidence from two birth cohort studies

Kaseva, Nina; Vääräsmäki, Marja; Matinolli, Hanna‐Maria; Sipola-Leppänen, Marika; Tikanmäki, Marjaana; Heinonen, Kati; Lano, Aulikki; Wolke, Dieter; Andersson, Sture; Järvelin, Marjo‐Riitta; Räikkönen, Katri; Eriksson, Johan G.; Kajantie, Eero

doi:10.1038/ijo.2017.277

Cited by 49 publications

(51 citation statements)

References 23 publications

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“…Newborns of mothers with GDM are heavier and have greater skinfold measures and adiposity than offspring of mothers without GDM. Later in life, children of diabetic mothers more frequently develop early overweight or obesity, type 2 diabetes, and metabolic syndrome [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

Alba

Pazos

Cortés

et al. 2020

BMC Pregnancy Childbirth

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Background: Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods: This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results: Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5).LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions:In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st.

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Section: Introductionmentioning

confidence: 99%

“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

Alba

Pazos

Cortés

et al. 2020

BMC Pregnancy Childbirth

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“…Obesity and diabetes disproportionately affect minority women, and the intrauterine environment contributing to the epidemics will perpetuate and widen health disparities between racial and ethnic groups (Verbiest, Malin, Drummonds, & Kotelchuck, ). Adverse intergenerational life course trajectories with diabetes and obesity will continue to spiral, unless this cycle is interrupted (Kaseva et al., ).…”

Section: Background and Aimsmentioning

confidence: 99%

A Practice‐Based Research Database to Study Perinatal Nurse Home Visiting to Pregnant Women With Diabetes

Bloch

McKeever

Zupan³

et al. 2019

Worldviews Ev Based Nurs

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Background and Aims: Accumulation of real-world evidence from practice-based perinatal nurse home visits to pregnant women with diabetes prompted this translational perinatal health disparities research. Given the global diabetes epidemic, this academic-community partnered research team is studying the utilization, processes, and outcomes of this understudied model of perinatal nurse home visiting that provide home-based enhanced diabetes care to pregnant women. Because the nursing records provide the rich source of data for the study, our aim is to provide an in-depth description of the Philadelphia Pregnancy and Diabetes Home Visiting (PPD-HV) research database developed from data in the longitudinal nursing records.Methods: This descriptive study uses retrospective data abstracted from paper-based perinatal nurse home visiting clinical records to create the PPD-HV, a HIPAA compliant, secure REDCap electronic research database. The sample includes 248 urban, pregnant women with diabetes who received a total of 1,644 home visits during the year 2012. The setting was Philadelphia, a large metropolitan city in the northeastern part of the United States. The PPD-HV database followed the information fields of the paper-based clinical nursing forms, which were originally designed by following the Omaha System to guide documenting the nursing process used in caring for patients in their homes.

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“…Later in life, children of diabetic mothers more frequently develop early overweight or obesity, type 2 diabetes, and metabolic syndrome. [7][8][9] In pregnant woman with GDM, ultrasound is used to monitor growth as overnutrition is common and influences management. Prenatally, fetal overgrowth is suspected when the ultrasound estimated fetal weight (EFW) is abnormally elevated.…”

Section: Introductionmentioning

confidence: 99%

INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes

Alba

Pazos

Cortés

et al. 2020

Preprint

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Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of personalized fetal growth curves to identify newborns with alterations in nutritional status could exceed that of INTERGROWTH21st.

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Pre-pregnancy overweight or obesity and gestational diabetes as predictors of body composition in offspring twenty years later: evidence from two birth cohort studies

Abstract: Maternal pre-pregnancy overweight and GDM are associated with unhealthy body size and composition in offspring over 20 years later. Effects of maternal pre-pregnancy overweight appear more pronounced.

Cited by 49 publications

References 23 publications

“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

A Practice‐Based Research Database to Study Perinatal Nurse Home Visiting to Pregnant Women With Diabetes

INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes

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