The Effect of Maternal Body Mass Index on Perinatal Outcomes in Women with Diabetes

Marshall, Nicole; Guild, Camelia; Cheng, Yvonne W.; Caughey, Aaron B.; Halloran, Donna R.

doi:10.1055/s-0033-1347363

Cited by 8 publications

(3 citation statements)

References 32 publications

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“…In particular, there is a positive relationship between increasing maternal body mass index and higher infant birthweight. The findings of this study are consistent with both the wider literature on obesity in pregnancy [21] and maternal BMI ≥50 [8, 22]. Similarly, the association between maternal obesity with poor infant condition immediately after birth has been supported by both a wider maternal obesity review [23] and studies of pregnant women with BMI>50 [17].…”

Section: Discussionsupporting

confidence: 89%

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

McCall

Kurinczuk

et al. 2019

PLoS ONE

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ObjectiveTo examine the association between maternal BMI>50kg/m2 during pregnancy and maternal and perinatal outcomes.Materials and methodsAn international cohort study was conducted using data from separate national studies in the UK and Australia. Outcomes of pregnant women with BMI>50 were compared to those of pregnant women with BMI<50. Multivariable logistic regression estimated the association between BMI>50 and perinatal and maternal outcomes.Results932 pregnant women with BMI>50 were compared with 1232 pregnant women with BMI<50. Pregnant women with BMI>50 were slightly older, more likely to be multiparous, and have pre-existing comorbidities. There were no maternal deaths, however, extremely obese women had a nine-fold increase in the odds of thrombotic events compared to those with a BMI<50 (uOR: 9.39 (95%CI:1.15–76.43)). After adjustment, a BMI>50 during pregnancy had significantly raised odds of preeclampsia/eclampsia (aOR:4.88(95%CI: 3.11–7.65)), caesarean delivery (aOR: 2.77 (95%CI: 2.31–3.32)), induction of labour (aOR: 2.45(95% CI:2.00–2.99)) post caesarean wound infection (aOR:7.25(95%CI: 3.28–16.07)), macrosomia (aOR: 8.05(95%CI: 4.70–13.78)) compared a BMI<50. Twelve of the infants born to women in the extremely obese cohort died in the early neonatal period or were stillborn.ConclusionsPregnant women with BMI>50 have a high risk of inferior maternal and perinatal outcomes.

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Section: Discussionsupporting

confidence: 89%

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

McCall

Kurinczuk

et al. 2019

PLoS ONE

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“…Maternal BMI is also an established risk factor for accelerated fetal growth and increased birth weight and size (2, 3, 37, 38). Further, our group recently reported that the %FM at birth of neonates born to women with a pre-pregnancy BMI in the overweight or obese categories was significantly higher than the %FM of neonates born to women in the normal BMI category, a finding that sustained when further adjusted by total energy and diet quality in this analysis, further supporting the link between maternal BMI and infant adiposity (4).…”

Section: Discussionmentioning

confidence: 99%

Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study

et al. 2016

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Background and Objective Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass, %FM) at birth by increasing the fat mass (FM) component of neonatal body composition. Methods Our analysis was conducted using a pre-birth observational cohort of 1,079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-hour dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores ≤ 57 and scores > 57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 hours after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for pre-pregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex, and gestational age. Results Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, SD: 13.6). An HEI-2010 score ≤ 57 was significantly associated with higher neonatal %FM (β = 0.58, 95% CI 0.07, 1.1, p<0.05) and FM (β=20.74; 95% CI 1.49, 40.0; p<0.05) but no difference in FFM. Conclusions Poor diet quality during pregnancy increases neonatal adiposity independent of maternal pre-pregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

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“…Relatively few pregnant women with GDM require insulin therapy. Complications can be prevented by catching GDM early, correctly determining a diagnosis, and receiving optimal follow-up treatment (Calkins & Devaskar, 2011;Catalano et al, 2012;Marshall et al, 2014;Schneider et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Performing an oral glucose tolerance test during pregnancy

Kudlová¹,

Kočvarová²,

Vránová³

et al. 2021

Cent Eur J Nurs Midw

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Aim:The goal of this study was to establish the level of awareness amongst pregnant women in terms of preparation for an oral glucose tolerance test (oGTT), compare the results of two waves of data collection, and identify the most frequent preanalytical mistakes made in connection to the oGTT. Design: Comparison of 2 cross-sectional studies. Methods: From 2013-2017 two independent questionnaire studies were performed on a total of 477 pregnant women in the Olomouc and Zlín regions. A total of 225 respondents took part in Study 1 (2013)(2014), and a total of 252 in Study 2 (2016)(2017). Acquired data was analysed using descriptive statistics focused on the substantive significance of the results, as well as inference statistics. Results: Based on the sum index, the overall level of awareness had increased slightly amongst the women in Study 2 (by 0.41 points out of 5), Cohen's d = 0.3 suggests the effect was only mediocre. Fifteen erroneous processes were found. However, these had a decreasing trend once the guidelines had been unified. Conclusion: A more reliable performance of the oGTT in certified laboratories was declared by the respondents in Study 2. The level of awareness, and checking on their adherence to the regime before and during the course of measuring the oGTT in pregnant women was still inadequate. It is necessary to improve pregnant women's awareness of how to perform the oGTT correctly to ensure the least possible distortion of the results.

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The Effect of Maternal Body Mass Index on Perinatal Outcomes in Women with Diabetes

Cited by 8 publications

References 32 publications

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study

Performing an oral glucose tolerance test during pregnancy

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