scholarly journals Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women

2020 ◽  
Author(s):  
Xueyin Wang ◽  
Xiaosong Zhang ◽  
Min Zhou ◽  
Juan Juan ◽  
Xu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Cesarean Delivery ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Urban Women ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background: The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women, and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes. Methods: A retrospective analysis included 8,844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect the information on demographic characteristics, lifestyle behavior, medical history and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes, and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index and gestational weight gain for the risk of pregnancy outcomes. Results: 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery (Odds Ratio [OR] =1.69, 95% CI [confidence interval]: 1.48-1.92), preterm birth (OR=1.32, 95% CI: 1.07-1.64), macrosomia (OR=1.69, 95% CI: 1.34-2.13) and large-for-gestational age (LGA, OR=1.43, 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery (P for interaction = 0.025), and the prevalence of cesarean delivery was higher in women with GDM than those unaffected of GDM regardless of maternal age (age <35 years: 58.5% vs. 44.3%; age ≥35 years: 67.7% vs. 64.3%). Women aged ≥35 years and above and having GDM had a 2.10-fold increased risk of cesarean delivery compared to those who was under 35 years old and did not having GDM (OR=2.10, 95% CI: 1.48-2.93).Conclusions: GDM was associated with increased risk of cesarean delivery, preterm birth, macrosomia and LGA in Chinese urban women, and there was the interaction between GDM and maternal age for the risk of cesarean delivery.

scholarly journals Association of Gestational Diabetes Mellitus with Adverse Pregnancy Outcomes and Its Interaction with Maternal Age in Chinese Urban Women

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xueyin Wang ◽  
Xiaosong Zhang ◽  
Min Zhou ◽  
Juan Juan ◽  
Xu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cesarean Delivery ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Urban Women ◽  
Adverse Pregnancy

Background. The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes. Methods. A retrospective analysis included 8844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect information on demographic characteristics, lifestyle behavior, medical history, and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index, and gestational weight gain for the risk of pregnancy outcomes. Results. 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery ( odds   ratio   OR = 1.69 , 95% CI (confidence interval): 1.48-1.92), preterm birth ( OR = 1.32 , 95% CI: 1.07-1.64), macrosomia ( OR = 1.69 , 95% CI: 1.34-2.13), and large for gestational age (LGA, OR = 1.43 , 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery ( P   for   interaction = 0.025 ), and the OR of GDM for cesarean delivery was 1.71 (95% CI: 1.49-1.97) among women aged less than 35 years. Conclusions. GDM was associated with an increased risk of cesarean delivery, preterm birth, macrosomia, and LGA in Chinese urban women, and there was an interaction between GDM and maternal age for the risk of cesarean delivery.

scholarly journals Effect of Endogenic and Exogenic Oxidative Stress Triggers on Adverse Pregnancy Outcomes: Preeclampsia, Fetal Growth Restriction, Gestational Diabetes Mellitus and Preterm Birth

2021 ◽  
Vol 22 (18) ◽  
pp. 10122
Author(s):  
Eun Hui Joo ◽  
Young Ran Kim ◽  
Nari Kim ◽  
Jae Eun Jung ◽  
Seon Ha Han ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fetal Growth ◽  
Pregnancy Outcomes ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Adverse Pregnancy

Oxidative stress is caused by an imbalance between the production of reactive oxygen species (ROS) in cells and tissues and the ability of a biological system to detoxify them. During a normal pregnancy, oxidative stress increases the normal systemic inflammatory response and is usually well-controlled by the balanced body mechanism of the detoxification of anti-oxidative products. However, pregnancy is also a condition in which this adaptation and balance can be easily disrupted. Excessive ROS is detrimental and associated with many pregnancy complications, such as preeclampsia (PE), fetal growth restriction (FGR), gestational diabetes mellitus (GDM), and preterm birth (PTB), by damaging placentation. The placenta is a tissue rich in mitochondria that produces the majority of ROS, so it is important to maintain normal placental function and properly develop its vascular network to ensure a safe and healthy pregnancy. Antioxidants may ameliorate these diseases, and related research is progressing. This review aimed to determine the association between oxidative stress and adverse pregnancy outcomes, especially PE, FGR, GDM, and PTB, and explore how to overcome this oxidative stress in these unfavorable conditions.

scholarly journals Maternal age and adverse pregnancy outcomes: a population-based register study in Wuhan, China, 2011-2016

2020 ◽  
Author(s):  
Jiangxia Cao ◽  
Bingzheng Zhang ◽  
Yan Liu ◽  
Ting Yu ◽  
Yiming Zhang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Health Management Information System ◽  
Adverse Pregnancy

Abstract Background A trend towards increasing maternal age has been witnessed in China. Evidence from high-income countries has shown that older women have higher risks of various adverse pregnancy outcomes. However, few large, contemporary, population-based studies have adjusted for potential confounders in examining the association between maternal age and adverse pregnancy outcomes in China. Methods Data from the Wuhan Maternal and Child Health Management Information System including all women aged ≥20 years with live singleton pregnancies in 2011-2016 were analyzed. A range of adverse pregnancy outcomes including pregnancy induced hypertension disorder(PIH), gestational diabetes mellitus(GDM), cesarean delivery, postpartum hemorrhage, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and 5-min Apgar score<7 among women aged 20-24, 30-35 and ≥40 years were compared with women aged 25-29 years using binary logistic regression models, with social-demographic characteristics, pre-pregnancy BMI, parity, and fetal gender adjusted. Subgroup analyses by stratifying on parity were also performed. Results 415,632 women were included during the study period. Among them, 91536(22.0%) were aged 20-24 years, 203687(49.0%) were aged 25-29 years, 89883(21.6%) were aged 30-34 years, 26271(6.3%) were aged 35-39 years, and 4255 (1.0%) were aged ≥40 years. After adjusting for the potential confounders, older maternal age (≥30 years) was associated with higher risks of PIH, GDM, cesarean delivery, preterm birth, LGA, and 5-min Apgar score<7, but not with SGA. Relative to older multiparous women, older nulliparous women were more likely to experience cesarean delivery, preterm birth, and 5-min Apgar score<7. Conclusion Older maternal age is independently associated with various adverse pregnancy outcomes. The risks may occur earlier than the commonly used definition of advanced maternal age, and may also differ by parity. Ensuring age and parity specific clinical counseling, antenatal surveillance, and health interventions may be of great significance to improve older mother’s pregnancy outcomes.

scholarly journals A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes

2020 ◽  
Vol 9 (2) ◽  
pp. 582 ◽  
Author(s):  
Ana López-de-Andrés ◽  
Napoleón Perez-Farinos ◽  
Valentín Hernández-Barrera ◽  
María A. Palomar-Gallego ◽  
David Carabantes-Alarcón ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cesarean Delivery ◽  
Pregnancy Outcomes ◽  
Neonatal Morbidity ◽  
Population Based ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Adverse Pregnancy ◽  
Over Time

(1) Background: We examined trends in incidence and outcomes in women with existing type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) compared with a control group without diabetes. (2) Methods: This was an observational, retrospective epidemiological study using the National Hospital Discharge Database. (3) Results: There were 2,481,479 deliveries in Spain between 2009 and 2015 (5561 mothers with T1DM, 4391 with T2DM, and 130,980 with GDM). Incidence and maternal age of existing diabetes and GDM increased over time. Women with T2DM were more likely to have obstetric comorbidity (70.12%) than those with GDM (60.28%), T1DM (59.45%), and no diabetes (41.82%). Previous cesarean delivery, preeclampsia, smoking, hypertension, and obesity were the most prevalent risk factors in all types of diabetes. Women with T1DM had the highest rate of cesarean delivery (Risk Ratio (RR) 2.34; 95% Confidence Interval (CI) 2.26–2.43) and prolonged maternal length of stay. Labor induction was higher in T2DM (RR 1.99; 95% CI 1.89–2.10). Women with T1DM had more severe maternal morbidity (RR 1.97; 95% CI 1.70–2.29) and neonatal morbidity (preterm birth, RR 3.32; 95% CI 3.14–3.51, and fetal overgrowth, RR 8.05; 95% CI 7.41–8.75). (4) Conclusions: existing and GDM incidence has increased over time. We found differences in the prevalence of comorbidities, obstetric risk factors, and the rate of adverse obstetric outcomes among women with different types of diabetes. Pregnant women with diabetes have the highest risk of adverse pregnancy outcomes.

scholarly journals Gestational diabetes mellitus: Major risk factors and pregnancy-related outcomes: A cohort study

2021 ◽  
pp. 827-836
Author(s):  
Azam Kouhkan ◽  
Laily Najafi ◽  
Mojtaba Malek ◽  
Hamid Reza Baradaran ◽  
Roya Hosseini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Previous History ◽  
Family History Of Diabetes ◽  
History Of ◽  
Adverse Pregnancy

Background: Gestational diabetes mellitus (GDM) is a major pregnancy endocrine problem that has several confirmed risk factors and is associated with adverse pregnancy-related outcomes (PRO). Objective: To evaluate the relationship between GDM diagnosis and the associated risk factors of PRO (maternal, intrapartum, perinatal, and neonatal) in accordance with International Association of Diabetes and Pregnancy Study Groups criteria. Materials and Methods: This prospective cohort study was performed with 531 singleton parturient (265 GDM and 266 non-GDM). They were selected consecutively from referral hospitals, and the maternal, intrapartum, perinatal, and neonatal outcomes were assessed. Results: The major risk factors influencing the GDM diagnosis were maternal age, obesity, family history of diabetes, previous history of GDM, and previous history of macrosomia. In the comparison of PRO between the groups, significant associations were detected for emergency cesarean delivery, preeclampsia, polyhydramnios, premature rupture of membrane, preterm delivery, and neonatal hyperbilirubinemia in the GDM group. In the multivariate logistic regression analysis, a previous history of stillbirth was significantly associated with maternal and perinatal outcomes. The odds ratios (CI 95%) of the PRO in the women with a GDM diagnosis were: maternal = 2.43 (1.51-3.90), intrapartum = 2.05 (1.35- 3.11), perinatal = 2.00 (1.29-3.10), and neonatal = 1.68 (1.08-2.62). The PRO was significantly correlated with GDM diagnosis, but not with the risk factors. Conclusion: The adverse pregnancy outcomes were significantly correlated with GDM diagnosis, and the outcomes were not directly affected by the risk factors. Given the related adverse outcomes for mothers and offspring, early screening and management of GDM is necessary especially in Asians and in low-/middle-income countries. Key words: Gestational diabetes mellitus, Pregnancy outcomes, Risk factors.

scholarly journals The association between soy intake and risk of gestational diabetes mellitus: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wang ◽  
Biru Luo ◽  
Jie Xiang
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background The association between soy intake and adverse pregnancy outcomes remains unclear. The objectives of this study were to investigate the soy consumption of pregnant women in the second trimester and explore the prospective association between soy intake and the risk of adverse pregnancy outcomes. Methods Pregnant women between 13 and 24 weeks of gestation were recruited at a women’s and children’s hospital in southwest China from June to December 2019. Dietary intakes in the middle trimester were assessed by a semi-quantitative food frequency questionnaire. Participants were divided into the insufficient group (< 40 g/day) and the control group (≥40 g/day) according to daily soy consumption. Participants were followed up until delivery. Pregnancy outcomes including gestational diabetes mellitus (GDM), cesarean section, and macrosomia were obtained. Multiple logistic regression was used to analyze the association between soy intake and risk of adverse pregnancy outcomes. Sociodemographic information, histories of diseases, and duration of physical activities were obtained and used for covariate adjustments. Results A total of 224 participants were included in this study, of which identified 36 (16.1%) cases of GDM, and 120 (53.6%) cases of cesarean section. More than half (125, 55.8%) pregnant women consumed less soy than 40 g/day. Daily soy intake less than 40 g was associated with the increased risk of GDM (OR = 2.755 95%CI 1.230-6.174, P = 0.014) and cesarean section (OR = 1.792 95%CI 1.035-3.101, P = 0.037) without adjustment for confounders such as age, pre-pregnancy body mass index, parity, daily intake of vegetables, fruits, seafood and, nuts. After adjusting for these factors, daily soy intake of less than 40 g increased 2.116-fold risk of GDM (95%CI 1.228-7.907, P = 0.017), but not with the significantly increased risk of cesarean section. Conclusion Insufficient soy intake may increase the risk of GDM, suggesting adequate soy intake may have a beneficial role in the prevention of GDM. Trial registration Registration number: ChiCTR1900023721. Date of registration: June 9, 2019.

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.

Age-specific risk factors for adverse maternal and neonatal outcomes in Xiamen, China: A population-based retrospective study

2019 ◽  
Author(s):  
Yin-ling Chen ◽  
Li-li Han ◽  
Wei-juan Su ◽  
Fu-ping Lv ◽  
Zheng Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy

Abstract Background: Elderly mothers are increasingly in China. We are aims to explore whether association between pregnancy to delivery interval and adverse pregnancy outcomes is affected by maternal age. Methods: A population-based retrospective study was performed in Xiamen, China. Data were derived from the Medical Birth Registry of Xiamen from 2011 to 2018. Multivariable logistic regression was used to conduct multivariable analyses based on adjusting the factors to evaluate the effect of maternal age on pregnancy outcomes. Results: Among 77,859 pregnant women with specific age, gestational diabetes mellitus (GDM) risk were increased for women aged 40 years or older (42.9%; aRR, 3.84 (3.26-4.51); P < 0.001), but not for pregnant women aged less than 25 years (9.2%; aRR, 0.60 (0.54-0.68)). Increased cesarean, preterm birth, large-for-gestational age (LGA), and low birth weight risks were more pronounced for pregnant women aged 40 years or older (66.5%, 8.4%, 26.5%, and 6.7%, respectively; aRR, 3.77 (3.14-4.52), 1.26 (0.90-1.79), 1.31 (1.08-1.60), and 1.10 (0.74-1.65), respectively; all P < 0.001). Risk of Apgar < 7 at 5 minutes were increased for women < 25 years old compared with women 35 to 39 years old (0.2% vs. 0.1%; aRR, 2.05 (0.85-4.93) vs. 0.63 (0.14-2.86)). Conclusion: Advanced maternal age increased risk of adverse pregnancy outcomes. The risk ratio of GDM, cesarean, preterm birth, LGA, and low birth weight is higher, which suggests pregnant women should guard against related risk factors and choose an appropriate mode of production. Furthermore, pregnant women should choose an ideal age for pregnancy to make themselves and child healthy.

scholarly journals Prevalence and Complications of Pregestational and Gestational Diabetes in Saudi Women: Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Hayfaa Wahabi ◽  
Amel Fayed ◽  
Samia Esmaeil ◽  
Heba Mamdouh ◽  
Reham Kotb
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Pregnancy Outcomes ◽  
Saudi Women ◽  
Total Cohort ◽  
Increased Risk ◽  
The World ◽  
Adverse Pregnancy

The objectives of this study were to estimate the burden of diabetes and to explore the adverse pregnancy outcomes associated with pregestational diabetes mellitus (pre-GDM) and gestational diabetes mellitus (GDM) among the Saudi pregnant population. In this subcohort, we compared the maternal and the neonatal outcomes of diabetic women with pre-GDM and GDM to the outcomes of nondiabetic mothers who delivered during the same period. From the total cohort, 9723 women participated in this study. Of the participants, 24.2% had GDM, 4.3% had pre-GDM, and 6951 were nondiabetic. After adjustment for confounders, women with GDM had increased odds of delivering a macrosomic baby (OR: 1.6; 95% CI: 1.2–2.1). Women with pre-GDM were more likely to deliver by Cesarean section (OR: 1.65; CI: 1.32–2.07) and to have preterm delivery < 37 weeks (OR: 2.1; CI: 1.5–2.8). Neonates of mothers with pre-GDM were at increased risk of being stillbirth (OR: 3.66; CI: 1.98–6.72), at increased risk of admission to NICU (OR: 2.21; CI: 1.5–3.27), and at increased risk for being macrosomic (OR: 2.40; CI: 1.50–3.8). The prevalence of GDM and pre-GDM in the Saudi pregnant population is among the highest in the world. The conditions are associated with high maternal and neonatal morbidities and mortalities.

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