Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery among pregnant women: a national prevalence study of 11 provinces in Iran

Darbandi, Mitra; Rezaeian, Shahab; Dianatinasab, Mostafa; Yaghoobi, Halime; Soltani, Maryam; Etemad, Koorosh; Valadbeigi, Tannaz; Taherpour, Niloufar; Hajipour, Mahmoud

doi:10.15167/2421-4248/jpmh2021.62.4.1788

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…Pregnant women developing gestational diabetes had a higher probability of delivering by caesarean section [20], which may further increase the probability of diabetes mellitus type 2 and hypertension disease in mothers at the next stages of their life [21]. Preterm delivery, macrosomia, abortion, pulmonary distress, stillbirth, and neonatal deaths have been considered among the most common outcomes of gestational diabetes [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…There are also certain studies supporting evidence that caesarean section might be a risk factor of preterm birth, but other studies did not confirm this finding [18,19], reinforcing the need for further investigation. Women developing gestational diabetes also have a greater likelihood of pre-eclampsia and delivering by caesarean section [20], which further leads postnatally to increasing rates of type 2 diabetes and hypertension-related disorders [21]. Several evidence has also shown that mothers who deliver by caesarean section may be less probable to breastfeed, and/or more probable to delay breastfeeding initiation which may lead to increased rates of maternal and childhood adverse outcomes [22].…”

Section: Introductionmentioning

confidence: 99%

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Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Pavlidou,

Papadopoulou,

Alexatou

et al. 2023

Preprint

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Background: There is an exponential increase in caesarean sections with epidemic proportions worldwide, which is considered as a serious public health issue that influences negatively both maternal and childhood health. Aims: This study aimed to evaluate the associations between pre-dominant maternal risk factors and the prevalence of caesarean section in a representative sample of women from Greece. Methods: This is a cross-sectional study conducted on 5182 healthy, re-productive-aged women from 11 geographically diverse Greek areas after applying specific inclu-sion and exclusion criteria. Statistical analysis was applied to evaluate the impact of maternal so-ciodemographic, anthropometric, lifestyle and perinatal factors in the risk of caesarean section de-liveries. Results: A high prevalence of 56.4% of caesarean section deliveries was recorded in the study population. The incidence of caesarean sections reached to 51.5% in private hospitals in which an increasing rate of 47.5% for planned caesarean sections were noticed. Older maternal age, pre-pregnancy overweight and obesity, excess gestational weight gain, high rates of preterm birth, better economic status, smoking habits, and private type of birth hospital were significantly related with enhanced risk of caesarean section, independently of multiple confounding factors. Conclu-sions: Our study revealed that caesarean section rates are continuously increase, while several maternal risk factors, including especially pre-pregnancy overweight/obesity and excess gestational weight gain, cumulatively raise its prevalence which further increase the risk for postnatal adverse outcomes for both the mothers and their children. Emergent public health policies and strategies should be promoted to confront the predominant maternal risk factors-related with caesarean sec-tion and inform future mothers how to be prevented from them by applying healthier nutritional and lifestyle habits and to select caesarean section only due to emergency medical reasons. Alarmingly enough, targeted nutritional intervention strategies are strongly recommended to ef-fectively reduce the prevalence of maternal pre-pregnancy overweight/obesity and the excess gestational weight gain, which in turn may minimize the risk of childhood overweight/obesity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Pavlidou,

Papadopoulou,

Alexatou

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Pregnant women developing gestational diabetes had a higher likelihood of delivering by caesarean section [ 20 ], which may further increase the probability of diabetes mellitus type 2 and hypertension disease in mothers at the next stages of their life [ 21 ]. Preterm birth, high newborn body weight, abortion, pulmonary distress, stillbirth, and neonatal deaths have been considered among the most common adverse outcomes of gestational diabetes [ 20 , 21 ]. However, in our study, we found no association between caesarean section prevalence and gestational diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…There are also certain studies supporting that an increased caesarean sections’ rate might be a risk factor of preterm birth, but other studies did not confirm this finding [ 18 , 19 ], reinforcing the need for further investigation. Women developing gestational diabetes also have a greater likelihood of gestational hypertension and pre-eclampsia and delivering by caesarean section [ 20 ], which further leads postnatally to increasing rates of type 2 diabetes and hypertension-related disorders [ 21 ]. Much evidence has also shown that mothers who deliver by caesarean section do not frequently begin breastfeeding, or they postpone breastfeeding initiation, which could exert superior beneficial effects in both the mothers’ and their infants’ health [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study

Pavlidou,

Antasouras,

Papadopoulou

et al. 2023

Medical Sciences

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In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers’ and children’s health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

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“…GDM is emerging as an important public health concern due to its association with severe perinatal outcomes, such as perinatal death and congenital malformations [ 6 – 8 ]. Maternal diabetes-induced congenital malformations can affect any developing organ or system.…”

Section: Introductionmentioning

confidence: 99%

Associations of elevated glucose levels at each time point during OGTT with fetal congenital heart diseases: a cohort study of 72,236 births

Zhang,

Lai,

Zhang

et al. 2023

BMC Pregnancy Childbirth

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Background It remains unclear how the condition of glucose metabolism during pregnancy affects fetal outcomes. This study aimed to investigate the associations of gestational diabetes mellitus (GDM) and elevated glucose levels at each time point during oral glucose tolerance test (OGTT) with congenital heart disease (CHD) risk in offspring. Methods We conducted a retrospective cohort study of mothers with singleton pregnancies of 20 weeks or more registered at Maternal and Child Health Centers in Fujian Province, China. The OGTT results and offspring CHD occurrence were collected. We used logistic regression to analyse the association between elevated blood glucose at each time point during OGTT and CHD. Results A total of 71,703 normal and 533 CHD fetuses were included. Compared to the corresponding normal group, women with GDM, elevated blood glucose at different time points in OGTT (0 h ≥ 5.1 mmol/L, 1 h ≥ 10 mmol/L, and 2 h ≥ 8.5 mmol/L) showed an increased risk of CHD in offspring (adjusted OR = 1.41, 1.36, 1.37, and 1.41, all P < 0.05, respectively). Compared to group 1 (normal OGTT 0 h, 1 h and 2 h), the risk of CHD was higher in group 3 (normal OGTT 0 h and abnormal OGTT 1 h or 2 h) and group 4 (abnormal OGTT 0 h, 1 h and 2 h), OR = 1.53 and 2.21, all P < 0.05, respectively. Moreover, we divided participants by advanced maternal age, multipara, assisted reproduction, fetal sex, and others, similar associations were observed in the subgroup analyses. Conclusion Elevated blood glucose at different time points during OGTT was associated with CHD in offspring. Fetuses of pregnant women with GDM should be screened for a high risk of CHD.

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Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery among pregnant women: a national prevalence study of 11 provinces in Iran

Cited by 6 publications

References 30 publications

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study

Associations of elevated glucose levels at each time point during OGTT with fetal congenital heart diseases: a cohort study of 72,236 births

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