Obstetric outcomes among women with gestational diabetes by hospital location, teaching status, and volume

2022 ◽  
Vol 226 (1) ◽  
pp. S277
Author(s):  
Yue Song ◽  
Katherine Fitch ◽  
Brooke F. Mischkot ◽  
Bharti Garg ◽  
Alyssa R. Hersh ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Obstetric Outcomes ◽  
Teaching Status

scholarly journals Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marta Claramonte Nieto ◽  
Eva Meler Barrabes ◽  
Sandra Garcia Martínez ◽  
Mireia Gutiérrez Prat ◽  
Bernat Serra Zantop
Keyword(s):  
Risk Factor ◽  
Gestational Diabetes ◽  
Maternal Age ◽  
Placenta Previa ◽  
Significant Risk ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Chronic Hypertension ◽  
Mediterranean Population ◽  
Confounding Factors

Abstract Background Women of advanced maternal age (AMA) are a growing population, with higher obstetric risks. The Mediterranean population has specific characteristics different from other areas. Thus, the objective of this study was to establish a cut-off to define AMA in a selected mediterranean population coming from a tertiary referral private/mutual health hospital in Barcelona. Methods Retrospective cohort of euploid singleton pregnancies delivered from January 2007 to June 2017. Main maternal outcomes were: gestational diabetes, preeclampsia, placenta previa, c-section and prolonged hospitalization (≥ 7 days). Main adverse perinatal outcomes were: stillbirth, prematurity, preterm prelabor rupture of membranes, low birth weight, need of admission at a neonatal intensive care unit and perinatal mortality. Adjustment for confounding factors (smoking, previous comorbilities, parity, assisted reproductive techniques (ART) and obesity) was performed. Results A total of 25054 pregnancies were included. Mean maternal age was 34.7 ± 4.2 years, with 2807 patients in the group of age between 40 and 44 years (11.2%) and 280 patients ≥45 years (1.1%). Women at AMA had higher incidence of previous comorbilities (compared to the reference group of women < 30 years): prior c-section, chronic hypertension and obesity. In addition, they were more likely to use ART. After adjusting for confounding factors, maternal age was an independent and statistically significant risk factor for gestational diabetes (OR 1.66/2.80/3.14) for ages 30–39, 40–44 and ≥ 45 years respectively, c-section (OR 1.28/2.41/7.27) and placenta previa (OR 2.56/4.83) for ages 40–44 and ≥ 45 years respectively, but not for preeclampsia (neither early-onset nor late-onset). Risk of emergency c-section was only increased in women ≥45 years (OR, 2.03 (95% CI, 1.50–2.74). In the other groups of age, the increase in c-section rate was because of elective indications. Age ≥ 45 years was associated with iatrogenic prematurity < 37 weeks (OR 2.62, 95% CI 1.30–5.27). No other relevant associations between AMA and maternal or neonatal outcomes were found. Conclusions Maternal age is an independent risk factor for adverse obstetric outcomes. Age ≥ 40 years was associated to relevant increased risks and reveals to be an adequate cut-off to define AMA in our population.

scholarly journals 989: Obstetric outcomes and placental findings in gestational diabetes patients according to pre-gestational weight and weight gain

2018 ◽  
Vol 218 (1) ◽  
pp. S584-S585
Author(s):  
Hadas Ganer Herman ◽  
Ann Dekalo ◽  
Lora Jobran ◽  
Letizia Schreiber ◽  
Jacob Bar ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Obstetric Outcomes ◽  
Gestational Weight ◽  
Diabetes Patients

scholarly journals Association between Gestational Weight Gain, Gestational Diabetes Risk, and Obstetric Outcomes: A Randomized Controlled Trial Post Hoc Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1568 ◽  
Author(s):  
David Simmons ◽  
Roland Devlieger ◽  
Andre van Assche ◽  
Sander Galjaard ◽  
Rosa Corcoy ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
Lifestyle Interventions ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Post Hoc

Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m2 <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24–28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35–37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester.

scholarly journals The Role of Untimed Blood Glucose in Screening for Gestational Diabetes Mellitus in a High Prevalent Diabetic Population

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sarah Cuschieri ◽  
Johann Craus ◽  
Charles Savona-Ventura
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Fasting Blood Glucose ◽  
Diabetes Type 2 ◽  
Obstetric Outcomes ◽  
Oral Glucose ◽  
Stepwise Logistic Regression ◽  
Operating Characteristics ◽  
Screening Protocol

Global prevalence increase of diabetes type 2 and gestational diabetes (GDM) has led to increased awareness and screening of pregnant women for GDM. Ideally screening for GDM should be done by an oral glucose tolerance test (oGTT), which is laborious and time consuming. A randomized glucose test incorporated with anthropomorphic characteristics may be an appropriate cost-effective combined clinical and biochemical screening protocol for clinical practice as well as cutting down on oGTTs. A retrospective observational study was performed on a randomized sample of pregnant women who required an OGTT during their pregnancy. Biochemical and anthropomorphic data along with obstetric outcomes were statistically analyzed. Backward stepwise logistic regression and receiver operating characteristics curves were used to obtain a suitable predictor for GDM without an oGTT and formulate a screening protocol. Significant GDM predictive variables were fasting blood glucose (p=0.0001) and random blood glucose (p=0.012). Different RBG and FBG cutoff points with anthropomorphic characteristics were compared to carbohydrate metabolic status to diagnose GDM without oGTT, leading to a screening protocol. A screening protocol incorporating IADPSG diagnostic criteria, BMI, and different RBG and FBG criteria would help predict GDM among high-risk populations earlier and reduce the need for oGTT test.

scholarly journals Gestational diabetes mellitus and obstetric outcomes in a Ghanaian community

2018 ◽  
Vol 8 (1) ◽  
pp. 204
Author(s):  
Ahmed Tijani Bawah ◽  
Robert Amadu Ngala ◽  
Mohammed Mustapha Seini ◽  
Francis Abeku Ussher ◽  
Huseini Alidu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcome ◽  
Obstetric Outcomes ◽  
Retrospective Case ◽  
Family History Of Diabetes ◽  
Maternal Characteristics ◽  
History Of ◽  
Control Study

Background: This study was aimed at evaluating effect of Gestational diabetes mellitus (GDM) and maternal characteristics on pregnancy outcomes. GDM has several risk factors including; advanced maternal age, ethnic background, obesity and family history of diabetes mellitus. These pregnancy complications are associated with fetal morbidity and mortality and may lead to macrosomia and shoulder dystocia. Others are stillbirth, miscarriages, preterm and small for gestational age babies.Methods: This was a retrospective case-control study which compared maternal characteristics and pregnancy outcome among pregnant women with and without GDM. Diagnosis of GDM was done in accordance with the American Diabetes Association (ADA) criteria. Weight and height were determined and Body mass index (BMI) calculated. Pregnancy outcome was determined at the end of pregnancy and information on maternal characteristics obtained using questionnaire and patient folders.Results: Those who developed GDM were significantly older (OR=1.772; 95% CI=1.432-2.192; P<0.0001) and had higher BMI (OR=1.637; 95% CI=1.004-1.289; P=0.044) than those who did not. A significant number of those who developed GDM also had stillbirths (OR= 5.188; 95% CI=1.093-24.613; p=0.038) and cesarean deliveries (OR=14.362; 95% CI=3.661-56.335; p= 0.001).Conclusions: Women who develop GDM are more likely to deliver stillborn or macrosmic babies and may require surgical intervention in order to have normal deliveries.

scholarly journals First Trimester Biomarkers in the Prediction of Later Pregnancy Complications

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Stefan C. Kane ◽  
Fabricio da Silva Costa ◽  
Shaun Brennecke
Keyword(s):  
Risk Factors ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Preterm Birth ◽  
High Risk ◽  
Gestational Diabetes ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
High Risk Population ◽  
Maternal History

Adverse obstetric outcomes, such as preeclampsia, preterm birth, gestational diabetes, and fetal growth restriction, are poorly predicted by maternal history and risk factors alone, especially in nulliparae. The ability to predict these outcomes from the first trimester would allow for the early initiation of prophylactic therapies, institution of an appropriate model and location of care, and recruitment of a truly “high risk” population to clinical trials of interventions to prevent or ameliorate these conditions. To this end, development of adequately sensitive and specific predictive tests for these outcomes has become a significant focus of perinatal research. This paper reviews the biomarkers involved in these multiparametric tests and also outlines the performance of these tests and issues regarding their introduction into clinical practice.

scholarly journals Neonatal and obstetric outcomes in diet- and insulin-treated women with gestational diabetes mellitus: a retrospective study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarah H. Koning ◽  
Klaas Hoogenberg ◽  
Kirsten A. Scheuneman ◽  
Mick G. Baas ◽  
Fleurisca J. Korteweg ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Obstetric Outcomes

scholarly journals Gestational diabetes mellitus and obstetric outcomes in a Ghanaian community

2019 ◽  
Vol 32 ◽  
Author(s):  
Ahmed Tijani Bawah ◽  
Robert Amadu Ngala ◽  
Huseini Alidu ◽  
Mohammed Mustapha Seini ◽  
Joshua Dokurugu Kwame Wumbee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Obstetric Outcomes

scholarly journals Maternal and Perinatal Outcomes in Spontaneous Twins versus Twins Conceived By Ovulation Induction and Assisted Reproductive Techniques: A Cross-Section Study

2021 ◽  
pp. 1-8
Author(s):  
Diana Yousif Rashid ◽  
◽  
Shahla Kareem Alalaf ◽  
Mohammed Yousif Rashid ◽  
◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Gestational Diabetes ◽  
Postpartum Hemorrhage ◽  
Twin Pregnancy ◽  
Demographic Data ◽  
Mode Of Delivery ◽  
Neonatal Outcomes ◽  
Obstetric Outcomes ◽  
Twin Pregnancies ◽  
Second Twin

Twin pregnancies have a higher perinatal mortality and morbidity and increased obstetrical complications compared with singleton pregnancies, and assisted reproduction techniques (ART) have increased twin pregnancy rates. This study was performed to compare perinatal and obstetric outcomes of dichorionic twin pregnancy following ART with those from spontaneous pregnancy. This cross-sectional study was performed in the Erbil Maternity Teaching Hospital. Two-hundred dichorionic twin pregnancies were classified into two groups: spontaneous (n = 121) and ART (n = 79) groups. Basic criteria included demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, anemia, blood transfusion, postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, neonatal intensive care unit admission, respiratory distress, and sepsis). The rates of pregnancy induced by hypertension, gestational diabetes, and pre-labor preterm rupture of membrane were significantly higher in the ART group, but postpartum hemorrhage, blood transfusion, anemia, were not significantly different. The majority of women in the ART group delivered by caesarean section. The risks of preterm birth, low neonatal birth weight and congenital malformation, and moderately depressed Apgar scores were higher in the ART group, while no significant differences were detected regarding other outcomes. In our study, the second twin had a worse outcome compared with the first twin in both groups of conception. Maternal and neonatal outcomes were poorer in the ART group. The second twin had a worse outcome compared with the first twin in both groups.

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