Maternal obesity and degree of glucose intolerance on neonatal hypoglycaemia and birth weight: a retrospective observational cohort study in women with gestational diabetes mellitus

ObjectiveThe aim of the present study was to investigate whether 25-hydroxyvitamin D (25(OH)D) status at 24–28 weeks is associated with blood lipids and pregnancy outcomes in patients with gestational diabetes mellitus (GDM).DesignWe performed an observational cohort study.SettingThe study was conducted in China.ParticipantsA total of 261 pregnant women diagnosed with GDM at 24–28 weeks of gestation in our hospital were included between June 2015 and December 2017. According to the levels of 25(OH)D, the women were divided into the G1 (<20 ng/mL) and G2 (≥20 ng/mL) groups. The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), TG/HDL-c and TC/HDL-c ratios were obtained from medical records. Pregnancy outcomes included gestational weeks of birth and delivery mode. Newborn information included birth weight and body length. Differences between groups were tested with adjusted multiple linear regression.ResultsThe serum levels of 25(OH)D (14.1±3.4 ng/mL vs 28.5±6.5 ng/mL, p<0.001), TC (5.3±0.9 vs 5.6±0.8, p=0.006), HDL-c (1.8±0.4 vs 1.9±0.4, p=0.046) and LDL-c (2.5±0.6 vs 2.7±0.7, p=0.015) in the G2 group were significantly higher than those in G1 group, while TG/HDL-c ratios (1.43±0.7 vs 1.26±0.7, p=0.035) were significantly higher in the G1 group. Moreover, we failed to find a significant difference in pregnancy outcomes of mothers and newborns among the two groups (p>0.05). In models adjusting for maternal age, parity, height, blood pressure, socioeconomic status, educational attainment, pre-pregnancy body mass index, season and gestational age, maternal 25(OH)D was associated with TG/HDL-c ratios (B=−0.016; 95% CI= −0.025 to –0.006).ConclusionWe found that there was no relationship between vitamin D and pregnancy/neonatal outcomes in our study. Maternal 25(OH)D at 24–28 weeks was inversely associated with TG/HDL-c ratios.

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Safe threshold of capillary blood glucose for predicting early future neonatal hypoglycaemia in babies born to mothers with gestational diabetes mellitus, an observational, retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03973-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Esther H. G. Park ◽

Frances O’Brien ◽

Fiona Seabrook ◽

Jane Elizabeth Hirst

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Capillary Blood ◽

Capillary Blood Glucose ◽

Neonatal Hypoglycaemia

Abstract Background There is increasing pressure to get women and babies home rapidly after birth. Babies born to mothers with gestational diabetes mellitus (GDM) currently get 24-h inpatient monitoring. We investigated whether a low-risk group of babies born to mothers with GDM could be defined for shorter inpatient hypoglycaemia monitoring. Methods Observational, retrospective cohort study conducted in a tertiary maternity hospital in 2018. Singleton, term babies born to women with GDM and no other risk factors for hypoglycaemia, were included. Capillary blood glucose (BG) testing and clinical observations for signs of hypoglycaemia during the first 24-h after birth. BG was checked in all babies before the second feed. Subsequent testing occurred if the first result was < 2.0 mmol/L, or clinical suspicion developed for hypoglycaemia. Neonatal hypoglycaemia, defined as either capillary or venous glucose ≤ 2.0 mmol/L and/or clinical signs of neonatal hypoglycaemia requiring oral or intravenous dextrose (lethargy, abnormal feeding behaviour or seizures). Results Fifteen of 106 babies developed hypoglycaemia within the first 24-h. Maternal and neonatal characteristics were not predictive. All babies with hypoglycaemia had an initial capillary BG ≤ 2.6 mmol/L (Area under the ROC curve (AUC) 0.96, 95% Confidence Interval (CI) 0.91–1.0). This result was validated on a further 65 babies, of whom 10 developed hypoglycaemia, in the first 24-h of life. Conclusion Using the 2.6 mmol/L threshold, extended monitoring as an inpatient could have been avoided for 60% of babies in this study. Whilst prospective validation is needed, this approach could help tailor postnatal care plans for babies born to mothers with GDM.

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Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus

PEDIATRICS ◽

10.1542/peds.2004-1808 ◽

2005 ◽

Vol 115 (3) ◽

pp. e290-e296 ◽

Cited By ~ 1359

Author(s):

C. M. Boney

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Birth Weight ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Maternal Obesity

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The association between gestational diabetes mellitus and birth-weight among Chinese women in Guangzhou : a retrospective cohort study

10.5353/th_b4299768 ◽

2009 ◽

Author(s):

Feng Shen

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Birth Weight ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chinese Women

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The association of serum gamma-glutamyltransferase and the incidence of type 2 diabetes mellitus based on propensity score matching: a retrospective observational cohort study

10.21203/rs.3.rs-36902/v2 ◽

2020 ◽

Author(s):

Buyuan Dong ◽

Ziwei Ji ◽

Leye He ◽

Hao Chen ◽

Mengxia Chen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Japanese Population ◽

Observational Cohort Study ◽

Gamma Glutamyltransferase ◽

Increased Risk ◽

Gender And Age ◽

Observational Cohort ◽

And Gender ◽

Retrospective Observational Cohort Study

Abstract Background: Previous studies reported that gamma-glutamyltransferase (GGT) may play an important role in the development of diabetes. The purpose of this study is to demonstrate that GGT is an independent risk factor for diabetes and to explore whether the association between GGT and the incidence of diabetes is affected by age and gender in the general Japanese population.Methods: This study is a retrospective observational cohort study. The study included 15464 men and women with an average age of 43.71 years from the Japanese health checkup program at Murakami Memorial Hospital from 2004 to 2015. The serum gamma-glutamyltransferase was stratified by quartiles. Patients were stratified by gender and age. Results: After adjusting for potential confounders, each additional standard deviation (SD) of GGT increases the risk of diabetes by 9%. The hazard ratio (HR) is 1.09 and the confidence interval (CI) is (1.01, 1.17). Participants in the fourth quartiles (Q4,≥ 22IU/L) had a higher risk of diabetes than the first to third quartiles (Q1-Q3) of GGT (HR: 1.47, 95 % CI: 1.15-1.87). Compared with males with lower GGT activity, males aged 40 to 50 years with GGT activity in the fourth quantile had a 53% increased risk of diabetes mellitus. Conclusions: GGT was positively correlated with the incidence of diabetes in the Japanese population. Especially in males aged 40-50 y, the higher the GGT, the higher the risk of developing diabetes.

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Association of maternal obesity with preterm birth phenotype and mediation effects of gestational diabetes mellitus and preeclampsia：a prospective cohort study

10.22541/au.161902976.62951001/v1 ◽

2021 ◽

Author(s):

kan liu ◽

yixuan chen ◽

xiaoxia wu ◽

fuying tian ◽

jianing tong ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Preterm Birth ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Obesity ◽

Mediation Effects ◽

Extremely Preterm

Objectives: To clarify the relationship between prepregnancy body mass index (BMI) and the phenotypes of preterm birth and evaluate the mediation effects of gestational diabetes mellitus (GDM) and preeclampsia (PE) on the relationship between prepregnancy BMI and preterm birth. Design: Prospective cohort study Setting: Shenzhen Maternity & Child Healthcare Hospital Population or Sample: 42196 singleton livebirths Methods: Prospective cohort study using the Birth Cohort in Shenzhen (BiCoS) dataset. Main Outcome Measures: Preterm birth was defined as gestational age less than 37 weeks. Results: Risks of extremely, very, and moderately preterm birth increased with BMI, and the highest risk was observed for obese women with extremely preterm birth (OR 3.43, 95% CI 1.07 –10.97). Maternal obesity was significantly associated with spontaneous preterm labor (OR 1.98; 95% CI 1.13–3.47), premature rupture of the membranes (OR 2.04; 95% CI 1.08–3.86) and medically indicated preterm birth (OR 2.05; 95% CI 1.25–3.37). GDM and PE mediated 13.41% and 36.66% of the effect of obesity on preterm birth, respectively. GDM mediated 32.80% of the effect of obesity on spontaneous preterm labor and PE mediated 64.31% of the effect of obesity on medically indicated preterm birth. Conclusions: Maternal prepregnancy obesity was associated with all phenotypes of preterm birth, and the highest risks were extremely preterm birth and medically indicated preterm birth. GDM and PE partially mediated the association between obesity and preterm birth. Funding: NSFC(81830041, 81771611); Shenzhen Science and Technology Project (JCYJ20170412140326739) KEYWORDS: obesity, prepregnancy BMI, preterm birth, phenotype, gestational diabetes mellitus, preeclampsia

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