The Association Between Trimester-Specific Weight Gain and Severe Preeclampsia/Adverse Perinatal Outcome in Gestational Diabetes Mellitus Complicated by Preeclampsia: A Retrospective Case Study

Abstract

Introduction Gestational diabetes mellitus (GDM) and preeclampsia share many risk factors, e.g., gestational weight gain (GWG). Previous studies on the co-occurrence of these two diseases cannot powerfully clear up the effects of GWG on perinatal outcome. Methods A total of 329 pregnant women with GDM complicated by preeclampsia were enrolled. Clinical data of mothers and newborns were retrospectively analyzed, including baseline characteristics of pregnant women and pregnancy outcomes. We focused on the association between trimester-specific weight gain and severe preeclampsia (s-PE)/adverse perinatal outcomes in GDM complicated by preeclampsia, including cesarean section (C-sect), preterm birth, and large for gestational age birth (LGA). Regression analysis was used to adjust the impact of confounding factors, including height, age, parity, scarred uterus, and so on. Result By unconditional regression analysis, middle trimester excessive GWG is a risk factor for LGA [OR 6.586, 95% CI (2.254–19.242), AOR 6.481, 95% CI (2.213–18.981)]; late excessive GWG is a risk factor for s-PE and C-sect [OR 1.683, 95% CI (1.084–2.614), AOR 1.888, 95% CI (1.193–2.990); and OR 1.754, 95% CI (1.121–2.744), AOR 1.841, 95% CI (1.153–2.937)], excessive total GWG is a risk factor for LGA, and is a protective factor for the preterm [OR 5.920, 95% CI (2.479–14.139), AOR 5.602, 95% CI (2.337–13.431); and OR 0.448, 95% CI (0.248–0.841), AOR 0.429, 95% CI (0.235–0.783)]. Conclusions The trimester-specific weight gain has a significant impact on the perinatal outcomes among pregnant women with both GDM and preeclampsia. This study is helpful for carry out risk monitoring in time, identifying early warning signs, and improving maternal and infant health.

Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy

“…When using the Atalah standard, one in three pregnant women exceeded gestational weight gain recommendations, while it was one in two with the IOM2009 standards for women with a pre-pregnancy BMI between 18.5 and 19.9 kg/m 2 . Given the complications associated with excess gestational weight gain 17,18,19,20 , underestimating the number of women who gain more than the recommended weight has important implications for the risks, recommendations, and behaviors of patients 32 .…”

“…This acquires relevance since Chile is a country in the fourth stage of the Obstetric Transition 14 characterized by a low rate of maternal mortality, but with a high prevalence of obesity in pregnant women (32.4%) 15,16 . Furthermore, excessive gestational weight gain has been linked to higher risk of adverse neonatal outcomes 17,18,19,20 , greater postpartum weight retention 21 and higher prevalence of obesity 22,23,24 in mothers, who would face a new pregnancy in worse nutritional conditions. In 2020, the Chilean Ministry of Health adopted the WHO cut-off points and the accompanying gestational weight gain recommendations to the Atalah standard for UW and NW 25 .…”

LncRNA OIP5-AS1 Signatures as a Biomarker of Gestational Diabetes Mellitus and a Regulator on Trophoblast Cells

“…It is generally believed that the pathogenesis of GDM is complex, and GDM may be the result of heredity, environment, and other factors [4, 5]. According to previous reports, the prevalence rate of GDM in China is as high as 17.5% [6]. GDM causes various adverse pregnancy outcomes in both mothers and infants, and the incidence of short-term and long-term complications is high [7].…”

Comparison of neonatal complications in pre-eclamptic and spontaneous preterm labour in the Persian Gulf Hospital of Bandar Abbas City, Iran, from 2011-2016

“…Pre-eclampsia has been associated with a 5% reduction in birth weight and an increase of 4-times for small for gestational age (SGA) 9 . Conversely, the prevalence of large for gestational age (LGA) in the early stages of pre-eclampsia has been reported before the last two weeks of gestation 10 . Oxidative stress can also play a role in the pathogenesis of preeclampsia.…”