969: Long-term cardiovascular outcome of small for gestational age infants born to women with and without gestational diabetes mellitus

A prenatal diet affects materno-foetal outcomes. This is a post hoc analysis of the St. Carlos gestational diabetes mellitus (GDM) Prevention Study. It aims to evaluate the effect of a late first-trimester (>12 gestational weeks) degree of adherence to a MedDiet pattern—based on six food targets—on a composite of materno-foetal outcomes (CMFCs). The CMFCs were defined as having emergency C-section, perineal trauma, pregnancy-induced hypertension and preeclampsia, prematurity, large-for-gestational-age, and/or small-for-gestational-age. A total of 874 women were stratified into three groups according to late first-trimester compliance with six food targets: >12 servings/week of vegetables, >12 servings/week of fruits, <2 servings/week of juice, >3 servings/week of nuts, >6 days/week consumption of extra virgin olive oil (EVOO), and ≥40 mL/day of EVOO. High adherence was defined as complying with 5–6 targets; moderate adherence 2–4 targets; low adherence 0–1 targets. There was a linear association between high, moderate, and low adherence, and a lower risk of GDM, CMFCs, urinary tract infections (UTI), prematurity, and small-for-gestational-age (SGA) newborns (all p < 0.05). The odds ratios (95% CI) for GDM and CMFCs in women with a high adherence were 0.35((0.18–0.67), p = 0.002) and 0.23((0.11–0.48), p < 0.001), respectively. Late first-trimester high adherence to the predefined six food targets is associated with a reduction in the risk of GDM, CMFCs, UTI, prematurity, and SGA new-borns.

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A Mediterranean Diet with an Enhanced Consumption of Extra Virgin Olive Oil and Pistachios Improves Pregnancy Outcomes in Women Without Gestational Diabetes Mellitus: A Sub-Analysis of the St. Carlos Gestational Diabetes Mellitus Prevention Study

Annals of Nutrition and Metabolism ◽

10.1159/000495793 ◽

2018 ◽

Vol 74 (1) ◽

pp. 69-79 ◽

Cited By ~ 12

Author(s):

Carla Assaf-Balut ◽

Nuria García de la Torre ◽

Alejandra Duran ◽

Manuel Fuentes ◽

Elena Bordiú ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Virgin Olive Oil ◽

Caloric Intake ◽

Extra Virgin Olive Oil ◽

Large For Gestational Age ◽

Prevention Study

Aims: The aim of the study was to evaluate the effect of a Mediterranean diet (MedDiet), enhanced with extra virgin olive oil (EVOO) and nuts, on a composite of adverse maternofoetal outcomes of women with normoglycemia during pregnancy. Methods: This was a sub-analysis of the St Carlos gestational diabetes mellitus Prevention Study. Only normoglycemic women were analysed (697). They were randomized (at 8–12th gestational weeks) to: standard-care control group (337), where fat consumption was limited to 30% of total caloric intake; or intervention group (360), where a MedDiet, enhanced with EVOO and pistachios (40–42% fats of total caloric intake) was recommended. The primary outcome was a composite of maternofoetal outcomes (CMFOs): at least having 1 event of emergency C-section, perineal trauma, pregnancy-induced hypertension and preeclampsia, prematurity, large-for-gestational-age and small-for gestational-age. Results: Crude relative risk showed that the intervention was associated with a significant reduction in the risk of CMFOs (0.48 [0.37–0.63]; p = 0.0001), with a number-needed-to-treat = 5. Risk of urinary tract infections, emergency C-sections, perineal trauma, large-for-gestational-age and small-for gestational age new-borns were also significantly reduced. Conclusion: A MedDiet, enhanced with EVOO and nuts, was associated with a risk reduction of CMFOs in over 50% in normoglycemic pregnant women. Therefore, it might be a potentially adequate diet for pregnant women. Trial registration: Identifier ISRCTN84389045. The study was registered on September 27, 2013. Last edited on September 26, 2018

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The significance of placental ratios in pregnancies complicated by small for gestational age, preeclampsia, and gestational diabetes mellitus

Obstetrics & Gynecology Science ◽

10.5468/ogs.2014.57.5.358 ◽

2014 ◽

Vol 57 (5) ◽

pp. 358 ◽

Cited By ~ 13

Author(s):

Hee Sun Kim ◽

Soo Hyun Cho ◽

Han Sung Kwon ◽

In Sook Sohn ◽

Han Sung Hwang

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age

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Small-for-gestational age placentas associate with an increased risk of adverse outcomes in pregnancies complicated by either type I or type II pre-gestational diabetes mellitus

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2020.1767572 ◽

2020 ◽

pp. 1-6

Author(s):

Roman Starikov ◽

Phinnara Has ◽

Robert Wu ◽

D. Michael Nelson ◽

Mai He

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Adverse Outcomes ◽

Type I ◽

Type Ii ◽

Increased Risk

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Conception via Assisted Reproductive Techniques: an Independent Risk Factor for Poor Perinatal Outcome

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.04.02.04 ◽

2020 ◽

Vol 4 (2) ◽

Keyword(s):

Diabetes Mellitus ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Post Partum ◽

Assisted Reproductive Techniques ◽

Reproductive Techniques ◽

Post Partum Haemorrhage

Assisted Reproductive Techniques (ART) are well established treatments offered in the sub-fertile couple. As a consequence, obstetricians increasingly have to manage high risk pregnancies without any formal guidelines to follow. We carried out a retrospective cohort study to evaluate the risks of ART using data from 11875 women (11326 spontaneously conceived pregnancies and 549 using ART) in order to propose a policy to better manage them antenatally. Outcome measures included induction of labour, method of and gestation at delivery, gestational diabetes mellitus, and small for gestational age, anal sphincter injury, post-partum haemorrhage and neonatal morbidity and mortality. The ART group had higher rates of gestational diabetes mellitus (18.9% vs 9.4%, P <0.0001), small for gestational age (9.1% vs 5.6%, P=0.001), instrumental delivery (19.6 vs 11.8%, P<0.0001), emergency caesarean section (26.8% vs 15%, P<0.0001) and post-partum haemorrhage >1500mL (6.9% vs 3%, P<0.0001). Lower Apgar scores (2.6% vs 1.4%, P=0.03) and admission to neonatal unit were more likely in the ART group (10.2% vs 5.4%, P<0.0001). Our results suggest that antenatal monitoring for gestational diabetes mellitus and fetal growth, appropriate counselling regarding mode and timing of delivery and active management of 3rd stage of labour, are essential when managing high risk ART pregnancies.

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Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus

Frontiers in Pediatrics ◽

10.3389/fped.2021.741793 ◽

2021 ◽

Vol 9 ◽

Author(s):

Juncao Chen ◽

Huimin Xiao ◽

Yong Yang ◽

Yaping Tang ◽

Xiaoqi Yang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

First Year ◽

Retrospective Case ◽

Adverse Perinatal Outcomes ◽

First Year Of Life

We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23–2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05–4.00] and [1.05–16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33–8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55–3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25–25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18–2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

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