scholarly journals Size and Shape of Associations of OGTT as Well as Mediating Effects on Adverse Pregnancy Outcomes Among Women With Gestational Diabetes Mellitus: Population-Based Study From Southern Han Chinese

2020 ◽  
Vol 11 ◽  
Author(s):  
Zixing Zhou ◽  
Gengdong Chen ◽  
Dazhi Fan ◽  
Jiaming Rao ◽  
Pengsheng Li ◽  
...  
2019 ◽  
Vol 75 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Wei-juan Su ◽  
Yin-ling Chen ◽  
Pei-ying Huang ◽  
Xiu-lin Shi ◽  
Fang-fang Yan ◽  
...  

Background: It is unclear that how prepregnancy body mass index (BMI), gestational weight gain (GWG), and gestational diabetes mellitus (GDM) affect pregnancy outcomes in ­China. Thus, we explored how BMI, GWG, and GDM affect the risks of adverse pregnancy outcomes. Methods: We performed a retrospective, population-based study included all births in Xiamen, China, 2011–2018. Demographic data and pregnancy outcomes of 73,498 women were acquired from the Medical Birth Registry of Xiamen. Women were categorized into groups on prepregnancy BMI and GWG in order to assess the risk of pregnancy outcomes. Multivariable logistic regression was performed to evaluate risk factors. Results: Overall, 6,982 (9.37%) women were obese, and 8,874 (12.07%) women were overweight. Obese women are more vulnerable to cesarean delivery, preterm birth, large-for-gestational age (LGA), and macrosomia (crude OR [cOR] 2.00, 1.89–2.12; 1.35, 1.20–1.51; 2.12, 1.99–2.26; 2.53, 2.25–2.86, respectively, adjusted ORs 1.73, 1.62–1.84; 1.25, 1.10–1.42; 2.03, 1.90–2.18; 2.77, 2.44–3.16, respectively). Similar results were observed in overweight women (cORs 1.49, 1.42–1.57; 1.02, 0.91–1.15; 1.60, 1.50–1.70; 2.01, 1.78–2.26, respectively). Furthermore, women who gain weight in excessive group were 1.43, 2.06, and 2.16 times to deliver cesarean, LGA, and macrosomia, respectively. Additionally, GDM women were easily subjected to cesarean section, preterm birth, LGA, low birth weight, and macrosamia (cORs 1.52, 1.55, 1.52, 1.37, 1.27, respectively). Conclusions: Obesity prior to pregnancy, excessive GWG, and GDM were all associated with increased odds of cesarean, LGA, and macrosomia. Blood glucose and weight control before and during pregnancy are needed that may reduce the complications of pregnancy.


2020 ◽  
Vol 9 (9) ◽  
pp. 2732
Author(s):  
Ellen Deleus ◽  
Bart Van der Schueren ◽  
Roland Devlieger ◽  
Matthias Lannoo ◽  
Katrien Benhalima

Background: Pregnancies in women with a history of bariatric surgery are becoming increasingly prevalent. Surgically induced metabolic changes benefit mother and child, but can also lead to some adverse pregnancy outcomes. Knowledge about glucose homeostasis in these pregnancies could elucidate some of the mechanisms behind these outcomes. This review focusses on glucose homeostasis and birth weight. Methods: We considered papers dealing with glucose homeostasis, gestational diabetes mellitus (GDM) and/or small-for-gestational age infants (SGA) in pregnancies with a history of sleeve gastrectomy (SG) or Roux-en-y gastric bypass (RYGB). Results: Since an OGTT is unreliable to diagnose GDM in a pregnancy after bariatric surgery, the true incidence of GDM is unknown. Alternative screening strategies are needed. Furthermore, these pregnancies are marked by frequent hypoglycemic events as well as wide and rapid glycemic excursions, an issue that is very likely underreported. There is a lack of uniformity in reporting key outcomes and a large variation in study design and control population. Conclusion: Alteration of glucose homeostasis in a pregnancy after bariatric surgery should be further studied using unequivocal definition of key concepts. Glycemic control may prove to be a modifiable risk factor for adverse pregnancy outcomes such as the delivery of an SGA baby.


Author(s):  
Ada Admin ◽  
Tiange Sun ◽  
Fanhua Meng ◽  
Hongmei Zhao ◽  
Min Yang ◽  
...  

Chronic low-grade inflammation plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). In order to investigate the ability of different <a></a><a>inflammatory blood cell parameters</a> in predicting the development of GDM and pregnancy outcomes, 258 women with GDM and 1154 women without were included in this retrospective study. First-trimester neutrophil count outperformed white blood cell (WBC) count, and neutrophil-to-lymphocyte ratio (NLR) in the predictability for GDM. Subjects were grouped based on tertiles of neutrophil count during their first-trimester pregnancy. The results showed that as the neutrophil count increased, there was a step-wise increase in GDM incidence, as well as glucose and glycosylated hemoglobin (HbA1c) level, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), macrosomia incidence and newborn weight. Neutrophil count was positively associated with pre-pregnancy Body Mass Index (BMI), HOMA-IR and newborn weight. Additionally, neutrophil count was an independent risk factor for the development of GDM, regardless of the history of GDM. Spline regression showed that there was a significant linear association between GDM incidence and continuous neutrophil count when it exceeded 5.0 × 10<sup>9</sup>/L. This work suggested that first-trimester neutrophil count is closely associated with the development of GDM and adverse pregnancy outcomes.


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