scholarly journals Associations of early pregnancy BMI with adverse pregnancy outcomes and infant neurocognitive development

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Ting Chen ◽  
Ting Zhang ◽  
Chang Chen ◽  
Yin-Yin Xia ◽  
Ting-Li Han ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Overweight And Obesity ◽  
Adverse Pregnancy Outcomes ◽  
Psychomotor Development ◽  
Neurocognitive Development ◽  
Development Index ◽  
Increased Risk ◽  
Adverse Pregnancy

AbstractThe prevalence of overweight and obesity amongst reproductive women has been increasing worldwide. Our aim was to compare pregnancy outcomes and infant neurocognitive development by different BMI classifications and investigate whether early pregnancy BMI was associated with risks of adverse outcomes in a Southwest Chinese population. We analysed data from 1273 women enrolled in the Complex Lipids in Mothers and Babies (CLIMB) randomized controlled trial in Chongqing, China. Maternal BMI was classified as underweight, normal weight and overweight/obese according to the Chinese, WHO Asian, and WHO European standards. For the adverse pregnancy outcomes, after adjustment for potential confounders, an underweight BMI was associated with increased risk of small for gestational age (SGA) babies, and an overweight/obese BMI was associated with increased risk of maternal gestational diabetes mellitus (GDM), caesarean section (C-section), macrosomia and large for gestational age (LGA) babies. For infant neurocognitive development, 1017 mothers and their children participated; no significant differences were seen in the Mental Development Index (MDI) or the Psychomotor Development Index (PDI) between the three BMI groups. Our findings demonstrate that abnormal early pregnancy BMI were associated with increased risks of adverse pregnancy outcomes in Chinese women, while early pregnancy BMI had no significant influence on the infant neurocognitive development at 12 months of age.

scholarly journals Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jie Tang ◽  
Xinhong Zhu ◽  
Yanbing Chen ◽  
Dongming Huang ◽  
Henning Tiemeier ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Caesarean Delivery ◽  
Overweight And Obesity ◽  
Adverse Pregnancy Outcomes ◽  
Healthy Weight ◽  
Birth Injury ◽  
Increased Risk ◽  
Adverse Pregnancy

AbstractThis study investigated the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among women participated in the National Free Preconception Health Examination Project in Guangdong Province, China, and explored these associations according to maternal age. Pre-pregnancy BMI was classified into underweight (BMI < 18.5 kg/m2), healthy weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥ 28.0 kg/m2) according to Chinese criteria. Outcomes were preterm birth (PTB, delivery before 37 weeks of gestation), large for gestational age (LGA, birthweight above the 90th percentile for gestational age by infants’ sex), small for gestational age (SGA, birthweight below the 10th percentile for gestational age by infants’ sex), primary caesarean delivery, shoulder dystocia or birth injury, and stillbirth. Adjusted incidence risk ratios (aIRR) were calculated for underweight, overweight and obesity, respectively. Compared with healthy weight, underweight was associated with increased risk of PTB (aIRR 1.06, 95%CI 1.04–1.09) and SGA (1.23, 1.22–1.26) but inversely associated with LGA (0.83, 0.82–0.85), primary caesarean delivery (0.88, 0.87–0.90) and stillbirth (0.73, 0.53–0.99). Overweight was associated with increased risk of LGA (1.17, 1.14–1.19), primary caesarean delivery (1.18, 1.16–1.20) and stillbirth (1.44, 1.03–2.06), but inversely associated with SGA (0.92, 0.90–0.95) and shoulder dystocia or birth injury (0.86, 0.79–0.93). Obesity was associated with increased risk of PTB (1.12, 1.05–1.20), LGA (1.32, 1.27–1.37), primary caesarean delivery (1.45, 1.40–1.50), but inversely associated with SGA (0.92, 0.87–0.97). The aIRRs for underweight, overweight and obesity in relation to these adverse pregnancy outcomes ranged from 0.65 to 1.52 according to maternal age. In Chinese population, maternal pre-pregnancy BMI was significantly associated with the risk of adverse pregnancy outcomes and the risk differs according to maternal age. Further investigation is warranted to determine whether and how counselling and interventions for women with low or increased BMI before pregnancy can reduce the risk of adverse pregnancy outcomes.

scholarly journals Early-pregnancy intermediate hyperglycaemia and adverse pregnancy outcomes among women without gestational diabetes

2021 ◽  
Author(s):  
Yunzhen Ye ◽  
Yu Xiong ◽  
Qiongjie Zhou ◽  
Xirong Xiao ◽  
Xiaotian Li
Keyword(s):  
Preterm Birth ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Aims Universal early-pregnancy screening for overt diabetes reveals intermediate hyperglycaemia [fasting plasma glucose (FPG) (5.1–6.9 mM)]. We evaluated the association between early-pregnancy intermediate hyperglycaemia and adverse pregnancy outcomes among women without gestational diabetes. Methods This retrospective cohort study, conducted at the Obstetrics and Gynaecology Hospital, Shanghai, China, from 2013-2017. All singleton pregnancies with FPG≤6.9mM in early pregnancy and receiving 75-g oral glucose tolerance test (OGTT) were included. Women with pre-pregnancy diabetes were excluded. Subjects with normal OGTT were analysed. Pregnancy outcomes for FPG&lt;5.1 mM and intermediate hyperglycaemia were evaluated. The primary outcomes were large for gestational age (LGA) and primary caesarean section. Multivariate logistic regressions were conducted. Significance was defined as P&lt;0.05. Results Totally, 24479 deliveries were included, of which 23450 (95.8%) had normal OGTTs later in pregnancy (NGT). There were 807 (3.4%) women had FPG=5.1–6.9 mM in early pregnancy. Compared to the NGT group with FPG&lt;5.1 mM in early pregnancy (N=20692), the intermediate hyperglycaemia NGT group (N=693) had a higher age and BMI, and significantly higher rates of LGA, primary caesarean section, preterm birth, preeclampsia and neonatal distress. The rates of primary caesarean section (AOR 1.24, 95% CI 1.05–1.45), preterm birth (AOR 1.75, 95% CI 1.29–2.36) and neonatal distress (adjusted OR 3.29, 95% CI 1.57–6.89) remained significantly higher after adjustments for maternal age, BMI and other potential confounding factors. Conclusions Women with intermediate hyperglycaemia in early pregnancy are at an increased risk for adverse maternal-foetal outcomes, even with normal future OGTTs.

scholarly journals An Early Pregnancy HbA1c≥5.9% (41 mmol/mol) Is Optimal for Detecting Diabetes and Identifies Women at Increased Risk of Adverse Pregnancy Outcomes

Diabetes Care ◽  
2014 ◽  
Vol 37 (11) ◽  
pp. 2953-2959 ◽  
Author(s):  
Ruth C.E. Hughes ◽  
M. Peter Moore ◽  
Joanna E. Gullam ◽  
Khadeeja Mohamed ◽  
Janet Rowan
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Increased Risk ◽  
Adverse Pregnancy

The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

2021 ◽  
Author(s):  
Shamil D. Cooray ◽  
Jacqueline A. Boyle ◽  
Georgia Soldatos ◽  
Shakila Thangaratinam ◽  
Helena J. Teede
Keyword(s):  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Therapeutic Interventions ◽  
Clinical Prediction Model ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Individual ◽  
Personalized Risk

AbstractGestational diabetes mellitus (GDM) is common and is associated with an increased risk of adverse pregnancy outcomes. However, the prevailing one-size-fits-all approach that treats all women with GDM as having equivalent risk needs revision, given the clinical heterogeneity of GDM, the limitations of a population-based approach to risk, and the need to move beyond a glucocentric focus to address other intersecting risk factors. To address these challenges, we propose using a clinical prediction model for adverse pregnancy outcomes to guide risk-stratified approaches to treatment tailored to the individual needs of women with GDM. This will allow preventative and therapeutic interventions to be delivered to those who will maximally benefit, sparing expense, and harm for those at a lower risk.

scholarly journals Assessing the relationship between pregravid body mass index and risk of adverse maternal pregnancy and neonatal outcomes: prospective data in Southwest China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yue Chen ◽  
Ke Wan ◽  
Yunhui Gong ◽  
Xiao Zhang ◽  
Yi Liang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cesarean Delivery ◽  
Body Mass ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Southwest China ◽  
Adverse Pregnancy Outcomes ◽  
Relative Importance ◽  
Adverse Pregnancy

AbstractThe relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.

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