Update on gestational diabetes and adverse pregnancy outcomes

Abstract

Purpose of review To explore the recent literature concerning the effect of gestational diabetes (GDM) on adverse pregnancy outcomes (APO). Recent findings Literature search on PubMed, Medline and British Journal of Obstetrics and Gynaecology was conducted using keywords. Search fields were filtered down to include articles from 2019 onwards. GDM is common during pregnancy and is on the rise because of increasing in obesity rates. GDM tended to show an increased risk of APO compared with non-GDM. Treatment of these pregnancies tended to improve these outcomes, particularly for LGA and macrosomia. Additional factors such as prepregnancy BMI and gestational weight gain (GWG) were shown to influence risk. More studies are needed to determine the true effect on postpartum haemorrhage (PPH) and induction of labour (IOL). Summary The review agrees with the findings from previous studies and adds to the current literature. Early intervention to manage glycaemic control and GWG may help improve these outcomes. Public health strategies that tackle obesity rates will help to reduce prepregnancy BMI and, therefore, rates of GDM.

Probiotics Supplementation during Pregnancy: Can They Exert Potential Beneficial Effects against Adverse Pregnancy Outcomes beyond Gestational Diabetes Mellitus?

“…Even if there is heterogeneity among the existing clinical studies, most of them have supported that probiotics supplementation may decrease the risk of GDM by reducing its influencing metabolism characteristics, including blood glucose concentrations, lipids levels, inflammatory conditions, and oxidation biomarkers, all of which could lower GDM incidence among pregnant women [ 17 , 18 , 19 , 20 ]. GDM constitutes one of the most common perinatal risk factors which may negatively affect both the mother’s and fetus’ health, exerting severe short- and long-term harmful pregnancy effects if remained untreated [ 21 , 22 ]. Beyond GDM, pregestational maternal obesity, excessive gestational weight gain (GWG), gestational hypertensive disorders, macrosomia or low birth weight, preterm birth, lipid metabolism dysfunction, and fetal growth restriction within gestation could result in harmful pregnancy effects and complications [ 21 , 22 , 23 , 24 , 25 , 26 ].…”

“…GDM constitutes one of the most common perinatal risk factors which may negatively affect both the mother’s and fetus’ health, exerting severe short- and long-term harmful pregnancy effects if remained untreated [ 21 , 22 ]. Beyond GDM, pregestational maternal obesity, excessive gestational weight gain (GWG), gestational hypertensive disorders, macrosomia or low birth weight, preterm birth, lipid metabolism dysfunction, and fetal growth restriction within gestation could result in harmful pregnancy effects and complications [ 21 , 22 , 23 , 24 , 25 , 26 ].…”

Serum copeptin in women with gestational diabetes mellitus: A meta-analysis

“…Gestational diabetes mellitus (GDM) affects approximately 1%–14% of pregnancies globally [ 1–4 ]. Women with GDM have been shown to have higher risks of preterm birth, preeclampsia, instrumental delivery, type 2 diabetes mellitus, and cardiovascular diseases in the future [ 5–7 ]. Additionally, infants born to women with GDM may suffer from macrosomia, shoulder dystocia, prolonged labor, postpartum hypoglycemia, and metabolic disorders, such as obesity, impaired glucose tolerance, and early-onset diabetes [ 5–7 ].…”

Prevalance of impaired glucose tolerance and its association with adverse perinatal outcomes in non-gestational diabetes pregnancies

“…There are several adverse outcomes for pregnant women and their fetuses associated with GDM. Complications include higher risk for preeclampsia (PE), preterm delivery, operative and cesarean delivery, shoulder dystocia, birth trauma, stillbirth, hydramnios, fetal macrosomia and large for gestational age (LGA) infant, neonatal intensive care unit (NICU) admission, perinatal mortality, neonatal respiratory problems, hyperbilirubinemia and hypocalcemia (4)(5)(6)(7)(8)(9)(10)(11)(12).…”