scholarly journals Associations Between Insulin Resistance and Adverse Pregnancy Outcomes in Women With Gestational Diabetes Mellitus: a Retrospective Study

2021 ◽  
Author(s):  
Jing Lin ◽  
Hua Jin ◽  
Lei Chen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Second Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Adverse Pregnancy ◽  
The Relationship

Abstract Background: This study aimed to explore the relationship between insulin resistance (IR) and adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM), and to determine the risk factors for IR in women with GDM.Methods: This study employed a retrospective survey of 710 women diagnosed with GDM. Serum lipids, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and serum protein were measured in the first trimester (6-12 weeks), and OGTT and fasting insulin tests were performed in the second trimester (24-28 weeks). These results were then used to evaluate IR by homeostasis model assessment (HOMA). When HOMA-IR≥2.0, IR was diagnosed. The relationship between HOMA-IR and adverse pregnancy outcomes was analyzed by a logistic regression model, and multiple stepwise regression was used to analyze the risk factors of HOMA-IR. Results: GDM with IR was significantly associated with the hypertensive disorders of pregnancy and large for gestational age (LGA) (P=0.002, 0.012, respectively). Body mass index (BMI) before pregnancy, FPG, HbA1c, and total triglyceride (TG) in early pregnancy were all significantly positively correlated with IR in the second trimester (P<0.05), while age was significantly negatively correlated with IR (P<0.001). Conclusion: GDM combined with IR in the second trimester increases adverse pregnancy outcomes, especially the risk of hypertensive disorders of pregnancy and LGA. In addition, BMI before pregnancy, FPG, HbA1c, and TG in early pregnancy are all independent risk factors for IR.

scholarly journals Associations between insulin resistance and adverse pregnancy outcomes in women with gestational diabetes mellitus: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Lin ◽  
Hua Jin ◽  
Lei Chen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Second Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Adverse Pregnancy ◽  
The Relationship

Abstract Background This study aimed to explore the relationship between insulin resistance (IR) and adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM), and to determine the risk factors for IR in women with GDM. Methods This study employed a retrospective survey of 710 women diagnosed with GDM. Serum lipids, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and serum protein were measured in the first trimester (6–12 weeks), and OGTT and fasting insulin tests were performed in the second trimester (24–28 weeks). These results were then used to evaluate IR by homeostasis model assessment (HOMA). When HOMA-IR ≥ 2.0, IR was diagnosed. The relationship between HOMA-IR and adverse pregnancy outcomes was analyzed by a logistic regression model, and multiple stepwise regression was used to analyze the risk factors of IR. Results IR significantly increasd the risk of the hypertensive disorders of pregnancy and large for gestational age (LGA) (OR = 5.31,95%CI:1.87,15.10; OR = 1.65,95%CI:1.10, 2.48, respectively) in women with GDM, but not for cesarean section, premature delivery, premature rupture of membranes, postpartum hemorrhage, macrosomia and SGA. Compared to normal groups, greater body mass index (BMI) before pregnancy category (overweight or obesity group) were associated with higher risk of IR in the second trimester, the OR (95% CI) were 4.09 (2.65, 6.30) and 6.52 (2.99, 14.20). And higher level of FPG (OR = 1.63, 95%CI: 1.11, 2.40), TG (OR = 1.32, 95%CI: 1.08, 1.63) and weight gain before diagnosis of GDM (OR = 1.08, 95%CI: 1.02, 1.15) were also associated with higher risk of IR in the second trimester in women with GDM, while age (OR = 0.94, 95%CI: 0.90, 0.98)was the weak protective factor for IR. Conclusion GDM with IR in the second trimester increased adverse pregnancy outcomes, especially the risk of hypertensive disorders of pregnancy and LGA. In addition, FPG, HbA1c, and TG in early pregnancy, pre-pregnant BMI and weight gain before diagnosis of GDM were all independent risk factors for IR.

Studies Assessing Risk of Treatments for Diabetes Mellitus and Adverse Pregnancy Outcomes Should Control for Known Risk Factors

2012 ◽  
Vol 14 (12) ◽  
pp. 1183-1184 ◽  
Author(s):  
E. Edson-Heredia ◽  
R.D. Rohwer ◽  
M. Wong ◽  
P. Wang ◽  
A. Vambergue ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

scholarly journals Assessing the relationship between adverse pregnancy outcomes and area-level deprivation in Wales 2014–2019: a national population-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052330
Author(s):  
Heather Brown ◽  
Amrita Jesurasa ◽  
Clare Bambra ◽  
Judith Rankin ◽  
Amy McNaughton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Pregnancy Outcomes ◽  
Emergency Caesarean Section ◽  
Adverse Pregnancy Outcomes ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Individual Level ◽  
Adverse Pregnancy ◽  
The Relationship

ObjectivesThe aim of this study was to assess the relationship between deciles of area-level deprivation and seven adverse pregnancy outcomes in Wales.DesignCross-sectional analysis.Setting64 699 live births in Wales from 31 March 2014 to 16 September 2019.Primary outcome variableWe examined each of the following seven adverse pregnancy outcomes: (1) small for gestational age (SGA); (2) large for gestational age; (3) preterm birth; (4) third-degree or fourth-degree perineal tear; (5) major postpartum haemorrhage (MPPH); (6) a lower Apgar score at 5 min and (7) emergency caesarean section.ResultsThere was no significant association between increasing aggregate measures of area-level deprivation and the adverse pregnancy outcomes we studied. Women living in an area with greater access to services are more likely to have a baby that is SGA (1.27, 95% CI 1.11 to 1.49), have a greater likelihood of a perineal tear (1.74, 95% CI 1.15 to 2.61), are significantly less likely to have MPPH (0.79, 95% CI 0.64 to 0.96), have a baby with an Apgar score of 0.26 higher (95% CI 0.22 to 0.29) and are significantly less likely to have an emergency caesarean section (0.81, 95% CI 0.73 to 0.88). Women living in areas with higher employment (0.26, 95% CI 0.19 to 0.36) and better health (0.26, 95% CI 0.19 to 0.35) were less likely to experience perineal tear.ConclusionsThere was no clear social-spatial gradient in area-level deprivation and adverse pregnancy outcomes. We found a stronger association for individual-level behavioural risk factors than area-level factors. These findings support the benefits that accessible and holistic person-centred care may bring through addressing individual behavioural risk factors. There is a need for improved data completeness and further individual-level data on risk factors such as employment and income to better understand the role which may be played by population-level policies and their pathways to affecting outcomes.

Increasing insulin resistance predicts adverse pregnancy outcomes in women with gestational diabetes mellitus

2020 ◽  
Vol 12 (6) ◽  
pp. 438-446 ◽  
Author(s):  
Yi‐Ying Sun ◽  
Juan Juan ◽  
Qian‐Qian Xu ◽  
Ri‐Na Su ◽  
Jane E. Hirst ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

scholarly journals Pregnancy outcomes in Chinese women with ulcerative colitis: A retrospective study of 23 pregnancies

2019 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
Juntao Liu ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Retrospective Study ◽  
Pregnancy Outcomes ◽  
Chinese Women ◽  
Adverse Pregnancy Outcomes ◽  
Active Group ◽  
Second Trimester ◽  
Significant Difference ◽  
Adverse Pregnancy ◽  
The Relationship

Abstract Background: Although China has a large population and increasing incidence of ulcerative colitis (UC), data on pregnancy outcomes in women with UC are insufficient and the relationship between simple clinical colitis activity index (SCCAI) and pregnancy outcomes has rarely been studied. This retrospective study aimed to assess the relationship between SCCAI and pregnancy outcomes of Chinese women with UC and explore factors affecting pregnancy outcomes. Methods: Overall, 23 pregnancies of 18 patients with UC were included. The following factors were analyzed: SCCAI before and during pregnancy; basic conditions, comorbidities, and treatment before and during pregnancy; frequency and details of pregnancy-related complications; and mode of delivery. Clinical characteristics, disease condition, and treatment details were compared between patients with and without adverse pregnancy outcomes. Results: The SCCAI was significantly lower in the remission group than in the active group (P < 0.001), except in the second trimester, but no significant difference in recurrence/exacerbation rate was found. There were 18 live births (remission group, 15; active group 3; P > 0.05). No significant difference in the frequency and characteristics of pregnancy-related complications was noted between the two groups. Outcomes of 15 pregnancies were satisfactory, but the other eight cases had adverse pregnancy outcomes. Patients with adverse pregnancy outcomes had higher SCCAI in the second trimester than the patients without adverse outcomes (P = 0.034). Multivariate analysis showed no statistically significant risk factor for adverse pregnancy outcomes. Conclusion: Chinese women with UC can usually achieve favorable pregnancy outcomes under multidisciplinary management, and a higher SCCAI in the second trimester has a positive correlation with adverse pregnancy outcomes.

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