scholarly journals Main Fetal Predictors of Adverse Neonatal Outcomes in Pregnancies with Gestational Diabetes Mellitus

2020 ◽  
Vol 9 (8) ◽  
pp. 2409
Author(s):  
Maria-Christina Antoniou ◽  
Leah Gilbert ◽  
Justine Gross ◽  
Jean-Benoît Rossel ◽  
Céline Julie Fischer Fumeaux ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Abdominal Circumference ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Adverse Neonatal Outcomes ◽  
The Impact

The objectives of this study were to (a) assess the utility of fetal anthropometric variables to predict the most relevant adverse neonatal outcomes in a treated population with gestational diabetes mellitus (GDM) beyond the known impact of maternal anthropometric and metabolic parameters and (b) to identify the most important fetal predictors. A total of 189 patients with GDM were included. The fetal predictors included sonographically assessed fetal weight centile (FWC), FWC > 90% and <10%, and fetal abdominal circumference centile (FACC), FACC > 90% and < 10%, at 29 0/7 to 35 6/7 weeks. Neonatal outcomes comprising neonatal weight centile (NWC), large and small for gestational age (LGA, SGA), hypoglycemia, prematurity, hospitalization for neonatal complication, and (emergency) cesarean section were evaluated. Regression analyses were conducted. Fetal variables predicted anthropometric neonatal outcomes, prematurity, cesarean section and emergency cesarean section. These associations were independent of maternal anthropometric and metabolic predictors, with the exception of cesarean section. FWC was the most significant predictor for NWC, LGA and SGA, while FACC was the most significant predictor for prematurity and FACC > 90% for emergency cesarean section. In women with GDM, third-trimester fetal anthropometric parameters have an important role in predicting adverse neonatal outcomes beyond the impact of maternal predictors.

Assessment of Gestational Diabetes Mellitus Outcomes for Hispanic Women Living in the Rio Grande Valley

2019 ◽  
Vol 17 (3) ◽  
pp. 111-117 ◽  
Author(s):  
Norma Somohano-Mendiola ◽  
Jane Dimmitt Champion ◽  
Kristina Vatcheva
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Hispanic Women ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Oral Glucose ◽  
Mexican Origin ◽  
Adverse Neonatal Outcomes

Introduction: Gestational diabetes mellitus (GDM) among women living along the U.S.–Mexico border are approximately twice that of the general population of pregnant U.S. women. This study compared outcomes for Hispanic pregnant women diagnosed and treated for GDM (i.e., two abnormal 3-hour oral glucose tolerance tests [OGTT]) with those who were screened but had only one abnormal 3-hour OGTT and therefore received no treatment. Methods: Retrospective chart review of pregnant Hispanic women of Mexican origin ( N = 95), with GDM ( N = 41) or one abnormal 3-hour OGTT value ( N = 54) who delivered between January 1, 2015, and December 31, 2017. Results: No significant differences were found between the two groups with regard to sociodemographic variables, hyperbilirubinemia, or other adverse neonatal outcomes. Comparisons identified differences between women with and without adverse neonatal outcomes concerned type of delivery; there were more C-sections among women with GDM. Conclusion: Pregnant women with one abnormal 3-hour OGTT value are at risk of giving birth to neonates with biomarkers similar to those diagnosed and treated for GDM. The treatment of hyperglycemia in Hispanic women of Mexican origin with one abnormal 3-hour OGTT value may improve the health outcomes and quality of life of the mother and the neonate. More research is warranted to clarify the risk of adverse outcomes of diverse pregnant women who do not meet guidelines for diagnosis of GDM.

scholarly journals Population-based study on birth outcomes among women with hypertensive disorders of pregnancy and gestational diabetes mellitus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ya-Wen Lin ◽  
Ming-Hung Lin ◽  
Lee-Wen Pai ◽  
Jen-Wei Fang ◽  
Chih-Hsin Mou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Birth Outcomes ◽  
Ductus Arteriosus ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Adverse Neonatal Outcomes

AbstractTo evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34–5.40) and 3.92 (95% CI 3.65–4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63–3.33) and 1.90 (95% CI 1.76–2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.

Gestational diabetes mellitus: Glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies

2018 ◽  
Vol 65 (6) ◽  
pp. 319-327
Author(s):  
María Augusta Guillén-Sacoto ◽  
Beatriz Barquiel ◽  
Natalia Hillman ◽  
María Ángeles Burgos ◽  
Lucrecia Herranz
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Singleton Pregnancies

scholarly journals Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

2021 ◽  
Vol 10 (4) ◽  
pp. 835
Author(s):  
Manoja P. Herath ◽  
Jeffrey M. Beckett ◽  
Andrew P. Hills ◽  
Nuala M. Byrne ◽  
Kiran D. K. Ahuja
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fat Mass ◽  
Metabolic Disorders ◽  
Later Life ◽  
Therapeutic Interventions ◽  
Increased Risk ◽  
The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

scholarly journals Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 506 ◽  
Author(s):  
Susana Contreras-Duarte ◽  
Lorena Carvajal ◽  
María Jesús Garchitorena ◽  
Mario Subiabre ◽  
Bárbara Fuenzalida ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vascular Function ◽  
Plasma Cholesterol ◽  
Umbilical Vein ◽  
Maternal Plasma ◽  
Maternal Weight ◽  
Cholesterol Levels ◽  
The Impact

Gestational diabetes mellitus (GDM) associates with fetal endothelial dysfunction (ED), which occurs independently of adequate glycemic control. Scarce information exists about the impact of different GDM therapeutic schemes on maternal dyslipidemia and obesity and their contribution to the development of fetal-ED. The aim of this study was to evaluate the effect of GDM-treatments on lipid levels in nonobese (N) and obese (O) pregnant women and the effect of maternal cholesterol levels in GDM-associated ED in the umbilical vein (UV). O-GDM women treated with diet showed decreased total cholesterol (TC) and low-density lipoproteins (LDL) levels with respect to N-GDM ones. Moreover, O-GDM women treated with diet in addition to insulin showed higher TC and LDL levels than N-GDM women. The maximum relaxation to calcitonin gene-related peptide of the UV rings was lower in the N-GDM group compared to the N one, and increased maternal levels of TC were associated with even lower dilation in the N-GDM group. We conclude that GDM-treatments modulate the TC and LDL levels depending on maternal weight. Additionally, increased TC levels worsen the GDM-associated ED of UV rings. This study suggests that it could be relevant to consider a specific GDM-treatment according to weight in order to prevent fetal-ED, as well as to consider the possible effects of maternal lipids during pregnancy.

scholarly journals Fetal Sex and Maternal Risk of Gestational Diabetes Mellitus: The Impact of Having a Boy

Diabetes Care ◽  
2015 ◽  
Vol 38 (5) ◽  
pp. 844-851 ◽  
Author(s):  
Ravi Retnakaran ◽  
Caroline K. Kramer ◽  
Chang Ye ◽  
Simone Kew ◽  
Anthony J. Hanley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fetal Sex ◽  
Maternal Risk ◽  
The Impact

scholarly journals Using Resistance Training in Women with Gestational Diabetes Mellitus to Improve Glucose Regulation

2021 ◽  
Author(s):  
Brittany R. Allman ◽  
Samantha McDonald ◽  
Linda May ◽  
Amber W. Kinsey ◽  
Elisabet Børsheim
Keyword(s):  
Diabetes Mellitus ◽  
Resistance Training ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Type Ii Diabetes Mellitus ◽  
Glucose Regulation ◽  
Pharmacological Treatments ◽  
Short And Long Term ◽  
The Impact

Gestational diabetes mellitus (GDM) poses a significant threat to the short- and long-term health of the mother and baby. Pharmacological treatments for GDM do not fully correct the underlying problem of the disease; however, non-pharmacological treatments such as exercise are increasingly recognized as foundational to glycemic management in other populations with disordered glucose regulation, such as non-gravid women with type II diabetes mellitus (T2DM). Much of the research regarding the impact of exercise on glycemic control in T2DM leverages aerobic training as the primary modality; yet research has demonstrated the effectiveness of resistance training on improving glycemic control in T2DM. This chapter will review the rationale for resistance training in the management of GDM using evidence from individuals with T2DM; then the chapter will review available studies on the effectiveness of resistance training on glucose control in women with GDM.

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