Faculty Opinions recommendation of Does weight management after gestational diabetes mellitus diagnosis improve pregnancy outcomes? A multi-ethnic cohort study.

2021 ◽  
Author(s):  
Katie Wynne
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Weight Management ◽  
Pregnancy Outcomes ◽  
Diabetes Mellitus Diagnosis

Early Diagnosed Gestational Diabetes Mellitus Is Associated With Adverse Pregnancy Outcomes: A Prospective Cohort Study

2020 ◽  
Vol 105 (12) ◽  
pp. e4264-e4274 ◽  
Author(s):  
Bin Liu ◽  
Jian Cai ◽  
Yun Xu ◽  
Yuhang Long ◽  
Langhui Deng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Early Diagnosis ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Early Onset ◽  
Prospective Cohort ◽  
Metabolic Disorders ◽  
Adverse Pregnancy

Abstract Context The significance of an early diagnosis of gestational diabetes mellitus (GDM) with oral glucose tolerance test (OGTT) has not been determined. Objective The objective of this work is to investigate GDM diagnosed by early and standard OGTTs and determine adverse maternal and neonatal outcomes associated with early GDM diagnosis. Research Design and Methods The Early Diagnosis of Gestational Diabetes Mellitus study is a prospective cohort study. Each participant in the study underwent 2 OGTTs, an early OGTT at 18 to 20 gestational weeks (gws) and a standard OGTT at 24 to 28 gws. The reproduciblity between early and standard OGTT were analyzed. Maternal and neonatal metabolic disorders and pregnancy outcomes were compared across groups. Results A total of 522 participants completed both the early and standard OGTTs. The glucose values in the early OGTT were not significantly different from those in the standard OGTT (fasting: 4.31 ± 0.41 mmol/L vs 4.29 ± 0.37 mmol/L, P = .360; 1-hour: 7.68 ± 1.71 mmol/L vs 7.66 ± 1.59 mmol/L, P = .826; 2-hour: 6.69 ± 1.47 mmol/L vs 6.71 ± 1.39 mmol/L, P = .800). The reproducibility of early and standard OGTT results was 74.9%. Pregnant women in the GDM group had higher glycated hemoglobin, C-peptide, and homeostasis model assessment of insulin resistance in the late gestational period. Neonates born to mothers in the GDM group were at a higher risk of being large for gestational age (odds ratio [OR]: 3.665; 95% CI, 1.006-11.91) and were also more prone to neonatal hyperinsulinemia (OR: 3.652; 95% CI, 1.152-10.533). Conclusion Early-onset GDM diagnosed by OGTT at 18 to 20 gws is associated with maternal and neonatal metabolic disorders and adverse pregnancy outcomes. Further randomized controlled trials on the therapeutic efficacy for early-onset GDM will confirm the significance of early screening for GDM.

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 Serum 25-hydroxyvitamin D levels in relation to lipids and clinical outcomes in pregnant women with gestational diabetes mellitus: an observational cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039905
Author(s):  
Wenqing Chen ◽  
Yuan Li ◽  
Bo Gao ◽  
Jie Li ◽  
Mingming Zheng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Density Lipoprotein ◽  
Observational Cohort Study ◽  
Hydroxyvitamin D ◽  
Observational Cohort ◽  
25 Hydroxyvitamin D

ObjectiveThe aim of the present study was to investigate whether 25-hydroxyvitamin D (25(OH)D) status at 24–28 weeks is associated with blood lipids and pregnancy outcomes in patients with gestational diabetes mellitus (GDM).DesignWe performed an observational cohort study.SettingThe study was conducted in China.ParticipantsA total of 261 pregnant women diagnosed with GDM at 24–28 weeks of gestation in our hospital were included between June 2015 and December 2017. According to the levels of 25(OH)D, the women were divided into the G1 (<20 ng/mL) and G2 (≥20 ng/mL) groups. The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), TG/HDL-c and TC/HDL-c ratios were obtained from medical records. Pregnancy outcomes included gestational weeks of birth and delivery mode. Newborn information included birth weight and body length. Differences between groups were tested with adjusted multiple linear regression.ResultsThe serum levels of 25(OH)D (14.1±3.4 ng/mL vs 28.5±6.5 ng/mL, p<0.001), TC (5.3±0.9 vs 5.6±0.8, p=0.006), HDL-c (1.8±0.4 vs 1.9±0.4, p=0.046) and LDL-c (2.5±0.6 vs 2.7±0.7, p=0.015) in the G2 group were significantly higher than those in G1 group, while TG/HDL-c ratios (1.43±0.7 vs 1.26±0.7, p=0.035) were significantly higher in the G1 group. Moreover, we failed to find a significant difference in pregnancy outcomes of mothers and newborns among the two groups (p>0.05). In models adjusting for maternal age, parity, height, blood pressure, socioeconomic status, educational attainment, pre-pregnancy body mass index, season and gestational age, maternal 25(OH)D was associated with TG/HDL-c ratios (B=−0.016; 95% CI= −0.025 to –0.006).ConclusionWe found that there was no relationship between vitamin D and pregnancy/neonatal outcomes in our study. Maternal 25(OH)D at 24–28 weeks was inversely associated with TG/HDL-c ratios.

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