Overweight and obesity : a remaining problem in women treated for severe gestational diabetes
| Autor: | Helena Fadl, Martina Persson, Ulf Hanson, Karin Hildén |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
endocrine system diseases
Epidemiology Endocrinology Diabetes and Metabolism Overweight Severity of Illness Index Fetal Macrosomia Cohort Studies 0302 clinical medicine Endocrinology Pre-Eclampsia Pregnancy Odds Ratio 030212 general & internal medicine Research Articles 030219 obstetrics & reproductive medicine Obstetrics Gestational age female genital diseases and pregnancy complications Gestational diabetes Endokrinologi och diabetes Female medicine.symptom Adult medicine.medical_specialty Gestational Age macromolecular substances Endocrinology and Diabetes Young Adult 03 medical and health sciences Internal medicine Diabetes mellitus Internal Medicine medicine Fetal macrosomia Humans Obesity Sweden Cesarean Section business.industry Odds ratio medicine.disease Pregnancy Complications Diabetes Gestational Logistic Models Case-Control Studies business Research: Epidemiology |
| Zdroj: | Diabetic Medicine |
| Popis: | Aim To analyse the impact of overweight and obesity on the risk of adverse maternal outcomes and fetal macrosomia in pregnancies of women treated for severe gestational diabetes. Methods This was a population‐based cohort study including all singleton pregnancies in Sweden without pre‐existing diabetes in the period 1998–2012. Only mothers with an early‐ pregnancy BMI of ≥ 18.5 kg/m² were included. Logistic regression analysis was used to determine odds ratios with 95% CIs for maternal outcomes and fetal growth. Analyses were stratified by maternal gestational diabetes/non‐gestational diabetes to investigate the impact of overweight/obesity in each group. Results Of 1 249 908 singleton births, 13 057 were diagnosed with gestational diabetes (1.0%). Overweight/obesity had the same impact on the risks of caesarean section and fetal macrosomia in pregnancies with and without gestational diabetes, but the impact of maternal BMI on the risk of preeclampsia was less pronounced in women with gestational diabetes. Normal‐weight women with gestational diabetes had an increased risk of caesarean section [odds ratio 1.26 (95% CI 1.16–1.37)], preeclampsia [odds ratio 2.03 (95% CI 1.71–2.41)] and large‐for‐gestational‐age infants [odds ratio 2.25 (95% CI 2.06–2.46)]. Risks were similar in the overweight group without gestational diabetes, caesarean section [odds ratio 1.34 (1.33–1.36)], preeclampsia odds ratio [1.76 (95% CI 1.72–1.81)], large‐for‐gestational‐age [odds ratio 1.76 (95% CI 1.74–1.79)]. Conclusions Maternal overweight and obesity is associated with similar increments in risks of adverse maternal outcomes and delivery of large‐for‐gestational‐age infants in women with and without gestational diabetes. Obese women with gestational diabetes are defined as a high‐risk group. Normal‐weight women with gestational diabetes have similar risks of adverse outcomes to overweight women without gestational diabetes. What's new? Maternal overweight and obesity is associated with similar increments in risks of adverse outcomes and delivery of large‐for‐gestational‐age infants in women with and without gestational diabetes.Overweight without gestational diabetes has a similar impact on the risk of maternal outcomes, such as preeclampsia, caesarean section and fetal macrosomia, as does gestational diabetes in women of normal weight.Obese women without gestational diabetes have higher rates of caesarean section, preeclampsia and macrosomia than normal‐weight women with gestational diabetes.Despite treatment, women with gestational diabetes still face excess risks of adverse pregnancy outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|