The obese woman with gestational diabetes: effects of body mass index and weight gain in pregnancy on obstetric and glycaemic outcomes

Ip, Flora; Bradford, Jennifer; Hng, Tien‐Ming; Hendon, Susan; McLean, Mark

doi:10.1258/om.2011.110009

Cited by 3 publications

(3 citation statements)

References 26 publications

(24 reference statements)

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“…Where there was evidence against the null hypothesis for the interaction factor (at p < 0.05), stratified analyses were conducted to assess effects of consultations for MNT and MNT + pharmacotherapy separately. Confounders were identified and adjusted for in the analyses, consistent with the literature [24][25][26]. For maternal complication outcomes, maternal age, early pregnancy BMI, gestational age at delivery, country of birth, LGA and previous caesarean section were adjusted for in the analyses.…”

Section: Discussionmentioning

confidence: 99%

Associations of a current Australian model of dietetic care for women diagnosed with gestational diabetes and maternal and neonatal health outcomes

Absalom,

Zinga,

Margerison

et al. 2023

BMC Health Serv Res

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Background Gestational diabetes mellitus (GDM) is a significant public health burden in Australia. Subsequent strain on healthcare systems is widespread and current models of care may not be adequate to provide optimal healthcare delivery. This study aimed to assess a current model of dietetic care with maternal and neonatal outcomes. Methods Hospital medical record data from The Women’s Hospital, Melbourne, for women with GDM (n = 1,185) (July 2105-May 2017) was retrospectively analysed. Adjusted linear and logistic regression were used to analyse associations between the number of dietitian consultations and maternal and neonatal health outcomes. Results Half of all women (50%) received two consultations with a dietitian. 19% of women received three or more consultations and of these women, almost twice as many were managed by medical nutrition therapy (MNT) and pharmacotherapy (66%) compared with MNT alone (34%). Higher odds of any maternal complication among women receiving 3 + consultations compared to those receiving zero (OR = 2.33 [95% CI: 1.23, 4.41], p = 0.009), one (OR = 1.80 [95% CI: 1.09, 2.98], p = 0.02), or two (OR = 1.65 [95% CI: 1.04, 2.60], p = 0.03) consultations were observed. Lower odds of infant admission to the Neonatal Intensive Care Unit (NICU) were observed among women receiving one (OR = 0.38 [95% CI: 0.18, 0.78], p = 0.008), two (OR = 0.37 [95% CI: 15 0.19, 0.71], p = 0.003), or three + consultations (OR = 0.43 [95% CI: 0.21, 0.88], p = 0.02), compared to no consultations. Conclusion The optimal schedule of dietitian consultations for women with GDM in Australia remains largely unclear. Alternate delivery of education for women with GDM such as telehealth and utilisation of digital platforms may assist relieving pressures on the healthcare system and ensure optimal care for women during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Associations of a current Australian model of dietetic care for women diagnosed with gestational diabetes and maternal and neonatal health outcomes

Absalom,

Zinga,

Margerison

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Based on previous literature examining GDM‐related outcomes, several confounders were identified and adjusted for in analyses. Maternal age, early pregnancy BMI, cultural background, LGA and gestational age at delivery were adjusted for when assessing the association between ‘GDM care’ and maternal complications (grouped and individual outcomes), consistent with previous studies . Previous caesarean section was also adjusted for because this is a common reason for having a caesarean section and has been controlled for in previous studies .…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, maternal age, parity, early pregnancy BMI, gestational age at delivery and cultural background were considered confounders for neonatal complications, based on previous literature . Consistent with previous studies, parity, early pregnancy BMI, gestational age at delivery, cultural background and infant sex were adjusted for when assessing the association between ‘GDM care’ and adverse infant birth size . In addition, bivariate correlations were used to determine potential confounders for dietetic intervention.…”

Section: Methodsmentioning

confidence: 99%

Associations of dietetic management with maternal and neonatal health outcomes in women diagnosed with gestational diabetes: a retrospective cohort study

Absalom

Zinga

Margerison

et al. 2019

J Human Nutrition Diet

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How to cite this article Absalom G., Zinga J., Margerison C., van der Pligt P. (2019) Associations of dietetic management with maternal and neonatal health outcomes in women diagnosed with gestational diabetes: a retrospective cohort study. J Hum Nutr Diet. 32, 728-736 https://doi. AbstractBackground: In 2010, the recommended diagnostic thresholds for gestational diabetes mellitus (GDM) were amended, which has increased GDM diagnoses, as well as pressure on the services involved in GDM management, specifically impacting dietetic workloads. The present study examined the associations between dietetic intervention in women with GDM and maternal and neonatal health outcomes. Methods: The present study involved 1233 adult women with GDM who delivered at The Royal Women's Hospital (RWH), Melbourne, Australia, between July 2015 and May 2017. Retrospective data assessing GDM-care (therapy type, diagnosis time and model of care, maternal and neonatal health outcomes, and outpatient dietetic consultations) were retrieved from patient medical records. Unadjusted and adjusted linear and logistic regression were used to assess associations of GDM care dietetic intervention and GDM care and dietetic intervention with maternal and neonatal health outcomes. Results: Women receiving dietetic intervention had a decreased likelihood of infant admission to the neonatal intensive care unit or special care nursery than women who not receiving dietetic intervention [adjusted odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.22-0.75; P = 0.004). Women requiring pharmacotherapy were more likely to experience maternal complications (adjusted OR = 3.13, 95% CI = 2.23-4.41; P < 0.001) and had a greater number of dietetic consultations (b-coefficient = 0.28, 95% CI = 0.17-0.39; P < 0.001) compared to women managed through diet. Conclusions: Dietetic intervention plays a key role in optimising maternal and neonatal health outcomes for women with GDM. Exploring further the impact of dietetic intervention in women diagnosed with GDM is key with respect to understanding the optimal delivery of care for these women. The type and number of consultations included in a dietetic intervention should be investigated further.728

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Benefit of insufficient gestational weight gain in obese women with gestational diabetes mellitus: A multicenter study in Portugal

Ferreira

Voss

Dória

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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The obese woman with gestational diabetes: effects of body mass index and weight gain in pregnancy on obstetric and glycaemic outcomes

Cited by 3 publications

References 26 publications

Associations of a current Australian model of dietetic care for women diagnosed with gestational diabetes and maternal and neonatal health outcomes

Associations of a current Australian model of dietetic care for women diagnosed with gestational diabetes and maternal and neonatal health outcomes

Associations of dietetic management with maternal and neonatal health outcomes in women diagnosed with gestational diabetes: a retrospective cohort study

Benefit of insufficient gestational weight gain in obese women with gestational diabetes mellitus: A multicenter study in Portugal

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