Risk of large for gestational age births at early, full and late term in relation to pre‐pregnancy body mass index: Mediation by gestational diabetes status

Author(s):  
Anthony J. Kondracki ◽  
Matthew J. Valente ◽  
Boubakari Ibrahimou ◽  
Zoran Bursac
2021 ◽  
Author(s):  
Catherine Knight-Agarwal ◽  
Jani Rati ◽  
Meisa Al-Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  

Abstract Background: The prevalence of maternal overweight and obesity has been increasing. This research explored the association between maternal body mass index and ethnicity in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus. Method: A retrospective cohort study was undertaken with 27 814 Australian women of various ethnicities, who gave birth to a singleton infant between 2008 and 2017. Variables were examined using logistic regression. Results: A significantly higher proportion of large for gestational age infants were born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women with a body mass index of ≥ 40kg/m2 had an adjusted odds ratio of 9.926 (3.859 - 25.535) for birthing a large for gestational age infant whereas Australian-born women had an adjusted odds ratio of 2.661 (2.256 - 3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin controlled gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational infant, in either the diet controlled, or insulin controlled gestational diabetes mellitus groups. Conclusion: Large for gestational age and gestational diabetes mellitus are adverse pregnancy outcomes that can lead to significant maternal and neonatal morbidity. Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine R. Knight-Agarwal ◽  
Rati Jani ◽  
Meisa Al Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  

Abstract Background The prevalence of gestational diabetes mellitus in Australia has been rising in line with the increased incidence of maternal overweight and obesity. Women with gestational diabetes mellitus, high body mass index or both are at an elevated risk of birthing a large for gestational age infant. The aim was to explore the relationship between country of birth, maternal body mass index with large for gestational age, and gestational diabetes mellitus. In addition to provide additional information for clinicians when making a risk assessment for large for gestational age babies. Method A retrospective cohort study of 27,814 women residing in Australia but born in other countries, who gave birth to a singleton infant between 2008 and 2017 was undertaken. Logistic regression analysis was used to examine the association between the aforementioned variables. Results A significantly higher proportion of large for gestational age infants was born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women residing in Australia, with a body mass index of ≥40 kg/m2, had an adjusted odds ratio of 9.926 (3.859–25.535) for birthing a large for gestational age infant. Conversely, Australian-born women with a body mass index of ≥40 kg/m2 had an adjusted odds ratio of 2.661 (2.256–3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin-requiring gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational age infant, in either the diet controlled, or insulin requiring gestational diabetes mellitus groups. Conclusions Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period to reduce their risk of adverse outcomes.


2013 ◽  
Vol 121 (6) ◽  
pp. 1255-1262 ◽  
Author(s):  
Sneha B. Sridhar ◽  
Assiamira Ferrara ◽  
Samantha F. Ehrlich ◽  
Susan D. Brown ◽  
Monique M. Hedderson

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S245-49
Author(s):  
Rabiah Anwar ◽  
Kashif Razzaq ◽  
Naheed Parveen

Objective: To evaluate the impact of obesity on maternal and neonatal outcome. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Pakistan Naval Ship, Shifa HospitalKarachi, from Nov 2016 to Oct 2017. Methodology: All singleton pregnant women of normal prepregnancy body mass index (BMI) and obese women having ≥30 body mass index, delivering newborn at 28-42 weeks of gestation were included. Comparison of antenatal complications and neonatal outcomes was done among both groups. Results: Obese women significantly developed gestational hypertension (OR=7.4 95% CI, 4.84-11.4), preeclampsia (OR=2.22 95% CI, 1.36-3.6), gestational diabetes mellitus (OR=5.2; 95% CI, 3.57-7.58), labor induction (OR= 2.79 95% CI, 2.03-3.84), failed induction of labor (OR = 5.3 95% CI, 8.05-29.38), cesarean delivery (OR=1.89 95% CI, 1.41-2.5), large for gestational age newborn (OR=3.97 95% CI, 2.87-5.50). But there was no statistically significant difference in small for gestational age newborn (OR=0.91 95% CI, 0.42-1.98), new born with APGAR score ≤7 after 5 min after delivery (OR=2.168 95% CI, 0.97-4.82) among obese and normal weight pregnant women. Conclusion: There is increased risk of gestational hypertension, preeclampsia, gestational diabetes, failed induction of labor, dystocia, cesarean delivery and large for gestational age newborns in obese women.Keywords: , , , , ,


2020 ◽  
Vol 7 (2) ◽  
pp. 218
Author(s):  
Sambit Das ◽  
Mahesh Rath ◽  
Lipsa Das ◽  
Kasturi Bharadwaj

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ≥92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ≥92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.


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