Pregnancy Outcomes Associated with Introduction of Early Diabetes Screening Guidelines

Author(s):  
Rebecca E. Weiss ◽  
Nevert Badreldin ◽  
Kathleen Drexler ◽  
Charlotte Niznik ◽  
Lynn M. Yee

Objective The study aimed to evaluate perinatal outcomes associated with introduction of and adherence to early diabetes screening guidelines. Study Design Retrospective cohort study of all women who received prenatal care at a single, high-volume tertiary care center before (“preguidelines”) and after (“postguidelines”) American College of Obstetrics and Gynecology guidelines for early pregnancy diabetes screening for women at high risk for diabetes. Women with known pregestational diabetes, late entry to prenatal care, a fetus with a known anomaly, or multiple gestation were excluded. Multivariable linear and logistic regression models were constructed to compare maternal and neonatal outcomes between women in the preguidelines cohort to those in the postguidelines cohort. Similarly, adherence to screening guidelines was assessed, and among all women who were eligible for early diabetes screening, multivariable linear, and logistic models were created to compare outcomes between those women who were screened early to those who were not. Results Of the 2,069 women eligible for analysis, 64.6% (n = 1,337) were in the postguideline cohort. Women in the postguideline cohort were older, less likely to have a history of smoking, and more likely to be non-Hispanic white. On multivariable analysis, women in the postguideline cohort had significantly less gestational weight gain (aβ = −2.3; 95% confidence interval [CI]: −3.4 to −1.1), but a higher odds of 5-minute Apgar's score of <7 (adjusted odds ratio: 2.51; 95% CI: 1.11–5.66). Of 461 women who met ACOG early diabetes screening criteria, 58.7% (n = 270) were screened appropriately. Adherence to screening was associated with parity, race, insurance, and BMI. On multivariable analysis, there were no significant differences in neonatal outcomes between women meeting early screening criteria who were screened early and those who were not. Conclusion Introduction of early diabetes screening guidelines was associated with a significant decrease in gestational weight gain, but did not improve neonatal outcomes. Key Points

Author(s):  
Thelma Brandão ◽  
Patricia de Carvalho Padilha ◽  
Denise Cavalcante de Barros ◽  
Karina dos Santos ◽  
Silvana Granado Nogueira da Gama ◽  
...  

2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Diana Gonzales‐Pacheco ◽  
Kim Cox ◽  
Cristina Murray‐Krezan

2016 ◽  
Vol 25 (2) ◽  
pp. 117-123 ◽  
Author(s):  
SeonAe Yeo ◽  
Jamie L. Crandell ◽  
Kathleen Jones-Vessey

2018 ◽  
Vol 63 (3) ◽  
pp. 283-288
Author(s):  
Michelle A. Kominiarek ◽  
Elizabeth Lucio Gray ◽  
Heidi Vyhmeister ◽  
William Grobman ◽  
Melissa Simon

Author(s):  
Reyna Sámano ◽  
Hugo Martínez-Rojano ◽  
Gabriela Chico-Barba ◽  
Bernarda Sánchez-Jiménez ◽  
Daniel Illescas-Zarate ◽  
...  

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25–7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Michelle A. Kominiarek ◽  
Adam K. Lewkowitz ◽  
Ebony Carter ◽  
Susan A. Fowler ◽  
Melissa Simon

Birth ◽  
2014 ◽  
Vol 41 (4) ◽  
pp. 353-359 ◽  
Author(s):  
Molly E. Waring ◽  
Tiffany A. Moore Simas ◽  
Katharine C. Barnes ◽  
Daniel Terk ◽  
Inna Baran ◽  
...  

2016 ◽  
Vol 29 (4) ◽  
pp. 445-455 ◽  
Author(s):  
Luana Patricia MARMITT ◽  
Carla Vitola GONÇALVES ◽  
Juraci Almeida CESAR

ABSTRACT Objective To measure and identify the factors associated with healthy weight gain during pregnancy in the municipality of Rio Grande, Rio Grande do Sul, Brazil. Methods This was a population-based, cross-sectional study that included all parturient women from the municipality who gave birth at its maternity hospitals in 2013. Information was collected by interview with the mothers in the first 48 hours following parturition and from the prenatal care cards. Healthy weight gain was evaluated according to the Institute of Medicine guidelines. Data analysis used Poisson regression with robust variance using previous hierarchical model. Results Among the 1,784 pregnant participants, 89% attended at least six prenatal care visits, and 32% had healthy weight gain during pregnancy. Higher education level and fewer children resulted in a higher prevalence ratio for healthy weight gain (p=0.003 and p=0.029, respectively). Underweight women at conception had a higher proportion of healthy weight gain (p<0.001). Despite extensive coverage, prenatal care did not affect healthy weight gain during pregnancy (p=0.104). Conclusion The low proportion of women with healthy gestational weight gain suggests a need of better prenatal care services. Women who are overweight, have lower education levels, and had had multiple pregnancies at conception need special attention.


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