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 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 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.

Neonatal outcome in pregnant patients with antiphospholipid syndrome

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Katarina Jeremic ◽  
Aleksandar Stefanovic ◽  
Jelena Dotlic ◽  
Jelena Stojnic ◽  
Sasa Kadija ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Distress Syndrome ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Distress Syndrome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Asphyxia ◽  
Premature Delivery ◽  
Control Group ◽  
Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

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 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 Analysis on the Effect of Metformin Hydrochloride Combined with Insulin Pump for Gestational Diabetes Mellitus

2022 ◽  
Author(s):  
Xinghua Li ◽  
Guilian Li ◽  
Yan Liu ◽  
Fanchun Meng ◽  
Lihong Han ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Research Group ◽  
Pregnancy Outcomes ◽  
Insulin Pump ◽  
Control Group ◽  
Metformin Hydrochloride ◽  
Tnf Α ◽  
Adverse Pregnancy

Background: U To analyze the effect of metformin hydrochloride combined with insulin pump for gestational diabetes mellitus (GDM). Methods: Overall, 216 patients with GDM in Zhangqiu Maternity and Child Care Hospital, Jinan, China from Aug 2018 to Dec 2020 were enrolled and randomized into research and control groups. Patients in the control group were treated with insulin pump, while those in the research group were treated with metformin hydrochloride combined with insulin pump. The clinical efficacy, blood glucose levels, serum Betatrophin, C reactive protein (CRP), Cystatin C (Cys-C), homocysteine (Hcy), adiponectin, tumor necrosis factor (TNF-α), interleukin-6 (IL-6) content, incidence of adverse pregnancy outcomes and incidence of adverse newborns of patients in the two groups were compared. Results: After treatment, the total clinical efficiency of the research group was 84.26%, significantly higher than that of the control group (68.52%). The levels of FPG, 2hPG, HbAlc, serum Betatrophin, CRP, CysC, Hcy, adiponectin factors, TNF-α, and IL-6 in the research group were lower than those in the control group, with statistically significant differences (P<0.05). The overall incidence of adverse pregnancy outcomes was 10.19% in the research group, and 25.93% in the control group. The comparative differences between the two groups were statistically significant (P<0.05). The overall incidence of adverse newborns was 9.26% in the research group, and 21.30% in the control group. The comparative differences between the two groups were statistically significant as well (P<0.05). Conclusion: Metformin hydrochloride combined with insulin pump for GDM can significantly reduce blood glucose level, regulate serum protein factor levels, and improve adverse outcomes for mother and child, which deserves clinical promotion.   

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