The effects of maternal body weight and gestational diabetes mellitus on the risk of the delivery of large-for-gestational age babies: Synergistic or additive?

Kuo, Shu-Chen; Lee, Wen-Ling; Wang, Peng-Hui

doi:10.1016/j.tjog.2022.03.004

Cited by 9 publications

(9 citation statements)

References 14 publications

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“…The association between pre-pregnancy BMI value and pregnancy outcomes remains inconclusive in women with PCOS. Additionally, we believe the fact that worse pregnancy outcomes are present in pregestational overweight/obese women, regardless of whether they are diagnosed with PCOS or not [ 22 , 23 , 24 , 25 , 26 ]. Therefore, we thus performed this systematic review and meta-analysis to elucidate the association between pre-pregnancy overweightness/obesity and pregnancy outcomes in the PCOS women.…”

Section: Introductionmentioning

confidence: 99%

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2022

IJERPH

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Polycystic ovary syndrome (PCOS) is a common metabolic problem in women of reproductive age. Evidence suggests pregnant women with PCOS may have a higher risk of the development of adverse pregnancy outcomes; however, the relationship between pre-pregnancy overweight/obesity and pregnancy outcomes in women with PCOS remains uncertain. We try to clarify the relationship between pre-pregnancy overweight/obesity and subsequent pregnancy outcomes. Therefore, we conducted this systematic review and meta-analysis. We used the databases obtained from the PubMed, Embase, Web of Science, and Cochrane databases, plus hand-searching, to examine the association between pre-pregnancy overweightness/obesity and pregnancy outcomes in women with PCOS from inception to 4 February 2022. A total of 16 cohort studies, including 14 retrospective cohort studies (n = 10,496) and another two prospective cohort studies (n = 818), contributed to a total of 11,314 women for analysis. The meta-analysis showed significantly increased odds of miscarriage rate in PCOS women whose pre-pregnancy body mass index (BMI) is above overweight (OR 1.71 [95% CI 1.38–2.11]) or obese (OR 2.00 [95% CI 1.38–2.90]) under a random effect model. The tests for subgroup difference indicated the increased risk was consistent, regardless which body mass index cut-off for overweight (24 or 25 kg/m2) or obesity (28 and 30 kg/m2) was used. With the same strategies, we found that pregnant women in the control group significantly increased live birth rate compared with those pregnant women with PCOS as well as pre-pregnancy overweight/obesity (OR 0.79 [95% CI 0.71–0.89], OR 0.78 [95% CI 0.67–0.91]). By contrast, we did not find any association between PCOS women with pre-pregnancy overweight/obesity and preterm birth. Based on the aforementioned findings, the main critical factor contributing to a worse pregnancy outcome may be an early fetal loss in these PCOS women with pre-pregnancy overweight/obesity. Since PCOS women with pre-pregnancy overweightness/obesity were associated with worse pregnancy outcomes, we supposed that weight reduction before attempting pregnancy in the PCOS women with pre-pregnancy overweightness/obesity may improve the subsequent pregnancy outcomes.

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Section: Introductionmentioning

confidence: 99%

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2022

IJERPH

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“…8 To sum up, it reminds clinicians of the importance of proper glycemic control in GDM women, monitoring GWG as well as taking pregestational BMI into consideration. 9 Healthcare providers should implement strategies to minimize the risk of macrosomia and avoid the consequence of both maternal and neonatal adverse events. We appreciate the authors’ great work focusing on this topic.…”

Section: Dear Editormentioning

confidence: 99%

Minimizing the risk of macrosomia

Yang

Liu

Wang

2023

Journal of the Chinese Medical Association

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“…Lifestyle modification is always considered as the front-line and best choice for all pre-DM and DM populations. 45–50 The critical and essential components of lifestyle medication include balanced food intake and caloric restriction with adequate nutrition support (grains, fruits, vegetables, proteins, seeds, nuts, and dairy), and an ideal body weight maintenance made by regular, appropriate, and tensely exercise. 51–55…”

Section: Introductionmentioning

confidence: 99%

“…Lifestyle modification is always considered as the front-line and best choice for all pre-DM and DM populations. [45][46][47][48][49][50] The critical and essential components of lifestyle medication include balanced food intake and caloric restriction with adequate nutrition support (grains, fruits, vegetables, proteins, seeds, nuts, and dairy), and an ideal body weight maintenance made by regular, appropriate, and tensely exercise. [51][52][53][54][55] A healthy lifestyle modification takes many advantages, not only for its safety and effectiveness for both pre-DM and DM, but also directly strengthening viability of all structures and organs in human beings, contributing to significant benefits.…”

Section: Introductionmentioning

confidence: 99%

To do one and to get more: Part II. Diabetes and metabolic dysfunction-associated fatty liver diseases

Lee

Wang

Yang

et al. 2022

Journal of the Chinese Medical Association

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Type 2 diabetes mellitus (DM) is characterized by inability of faulty pancreatic β-cells to secret a normal amount of insulin to maintain normal body consumption, and/or peripheral tissue has a decreased susceptibility to insulin, resulting in hyperglycemia and insulin resistance. Similar to other chronic systemic inflammatory diseases, DM is a result from dysregulated interactions between ethnic, genetic, epigenetic, immunoregulatory, hormonal, and environmental factors. Therefore, it is rational to suppose the concept as “To do one and to get more”, while using antidiabetic agents (ADA), a main pharmacologic agent for the treatment of DM, can provide an extraglycemia effect on comorbidities or concomittent comorbidities to DM. In this review, based on the much strong correlation between DM and metabolic dysfunction-associated fatty liver diseases (MAFLD) shown by similar pathophysiological mechanisms and a high prevalence of DM in MAFLD and its vice versa (a high prevalence of MAFLD in DM), it is possible to use the strategy to target both diseases simultaneously. We focus on a new classification of ADA, such as glucagon-like peptide-1 receptor (GLP1R) agonist and sodium-glucose cotransporter-2 (SGLT-2) inhibitors to show the potential benefits of extraglycemic effect on MAFLD. We conclude that the management of DM patients, especially for those who need ADA as adjuvant therapy should include healthy lifestyle modification to overcome the metabolic syndrome, contributing to the urgent need of an effective weight-reduction strategy. GLP1R agonist is one of effective body weight-lowering medications, which may be a better choice for DM complicated with MAFLD or its-associated severe form as metabolic associated steatohepatitis (MASH), although the role of SGLT-2 inhibitors is also impressive. The prescription of these two classes of ADA may satisfy the concept “To do one and to get more”, based on successful sugar-lowering effect for controlling DM and extraglycemia benefits of hepatoprotective activity in DM patients.

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The effects of maternal body weight and gestational diabetes mellitus on the risk of the delivery of large-for-gestational age babies: Synergistic or additive?

Cited by 9 publications

References 14 publications

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Minimizing the risk of macrosomia

To do one and to get more: Part II. Diabetes and metabolic dysfunction-associated fatty liver diseases

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