scholarly journals Are the Factors Affecting Adverse Pregnancy Outcomes Different in Obese Gestational Diabetes Pregnant Women Receiving Diet or Insulin Treatment?

2019 ◽  
Vol 15 (4) ◽  
pp. 472-481
Author(s):  
S Ozler
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Insulin Treatment ◽  
Adverse Pregnancy Outcomes ◽  
Factors Affecting ◽  
Adverse Pregnancy

scholarly journals Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

2001 ◽  
Vol 35 (6) ◽  
pp. 502-507 ◽  
Author(s):  
Luciana Bertoldi Nucci ◽  
Maria Inês Schmidt ◽  
Bruce Bartholow Duncan ◽  
Sandra Costa Fuchs ◽  
Eni Teresinha Fleck ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Educational Level ◽  
Adverse Pregnancy Outcomes ◽  
World Health ◽  
Prepregnancy Weight ◽  
Adverse Pregnancy ◽  
The Impact

INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

scholarly journals Burden, risk factors and outcomes associated with gestational diabetes in a population-based cohort of pregnant women from North India

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Stuti Bahl ◽  
Neeta Dhabhai ◽  
Sunita Taneja ◽  
Pratima Mittal ◽  
Rupali Dewan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Oral Glucose ◽  
Adverse Pregnancy

Abstract Background The burden of gestational diabetes mellitus (GDM) appears to be increasing in India and may be related to the double burden of malnutrition. The population-based incidence and risk factors of GDM, particularly in lower socio-economic populations, are not known. We conducted analyses on data from a population-based cohort of pregnant women in South Delhi, India, to determine the incidence of GDM, its risk factors and association with adverse pregnancy outcomes (stillbirth, preterm birth, large for gestational age babies) and need for caesarean section. Methods We analyzed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), an individually randomized factorial design trial. An oral glucose tolerance test (OGTT) was performed at the time of confirmation of pregnancy, and for those who had a normal test (≤140 mg), it was repeated at 24–28 and at 34–36 weeks. Logistic regression was performed to ascertain risk factors associated with GDM. Risk ratios (RR) were calculated to find association between GDM and adverse pregnancy outcomes and need for caesarean section. Results 19.2% (95% CI: 17.6 to 20.9) pregnant women who had at least one OGTT were diagnosed to have GDM. Women who had prediabetes at the time of confirmation of pregnancy had a significantly higher risk of developing GDM (RR 2.08, 95%CI 1.45 to 2.97). Other risk factors independently associated with GDM were woman’s age (adjusted OR (AOR) 1.10, 95% CI 1.06 to 1.15) and BMI (AOR 1.04, 95% CI 1.01 to 1.07). Higher maternal height was found to be protective factor for GDM (AOR 0.98, 95% CI 0.96 to 1.00). Women with GDM, received appropriate treatment did not have an increase in adverse outcomes and no increased need for caesarean section Conclusions A substantial proportion of pregnant women from a low to mid socio-economic population in Delhi had GDM, with older age, higher BMI and pre-diabetes as important risk factors. These findings highlight the need for interventions for prevention and provision of appropriate management of GDM in antenatal programmes. Clinical trial registration Clinical Trial Registry – India, #CTRI/2017/06/008908 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies).

scholarly journals Burden, Risk Factors and Outcomes Associated with Gestational Diabetes in A Population-Based Cohort of Pregnant Women from North India

2021 ◽  
Author(s):  
Stuti Bahl ◽  
Neeta Dhabhai ◽  
Sunita Taneja ◽  
Pratima Mittal ◽  
Rupali Dewan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Oral Glucose ◽  
Adverse Pregnancy

Abstract Background: The burden of gestational diabetes mellitus (GDM) appears to be increasing in India and may be related to the double burden of malnutrition. The population-based incidence and risk factors of GDM, particularly in lower socio-economic populations, are not known. We conducted analyses on data from a population-based cohort of pregnant women in South Delhi, India, to determine the incidence of GDM, its risk factors and association with adverse pregnancy outcomes (stillbirth, preterm birth, large for gestational age babies) and need for caesarean section. Methods: We analyzed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), an individually randomized factorial design trial. An oral glucose tolerance test (OGTT) was performed at the time of confirmation of pregnancy, and for those who had a normal test (≤140 mg), it was repeated at 24-28 and at 34-36 weeks. Logistic regression was performed to ascertain risk factors associated with GDM. Risk ratios (RR) were calculated to find association between GDM and adverse pregnancy outcomes and need for caesarean section. Results: 19.2% (95% CI: 17.6 to 20.9) pregnant women who had at least one OGTT were diagnosed to have GDM. Women who had prediabetes at the time of confirmation of pregnancy had a significantly higher risk of developing GDM (RR 2.08, 95%CI 1.45 to 2.97). Other risk factors independently associated with GDM were woman’s age (adjusted OR (AOR) 1.10, 95% CI 1.06 to 1.15) and BMI (AOR 1.04, 95% CI 1.01 to 1.07). Higher maternal height was found to be protective factor for GDM (AOR 0.98, 95% CI 0.96 to 1.00). Women with GDM, received appropriate treatment did not have an increase in adverse outcomes. However, GDM increased the need for caesarean section (RR 1.17, 95% CI 1.01 to 1.36).Conclusions: A substantial proportion of pregnant women from a low to mid socio-economic population in Delhi had GDM, with older age, higher BMI and pre-diabetes as important risk factors. These findings highlight the need for interventions for prevention and provision of appropriate management of GDM in antenatal programmes.Clinical Trial registration: Clinical Trial Registry – India, #CTRI/2017/06/008908 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies)

THE ASSOCIATED FACTORS AND PREGNANCY OUTCOMES OF WOMEN WITH DIABETES IN PREGNANCY

2018 ◽  
Vol 8 (5) ◽  
pp. 108-114
Author(s):  
Anh Nguyen Thi Kim
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Associated Factors ◽  
Adverse Pregnancy Outcomes ◽  
High Rate ◽  
Key Words Diabetes ◽  
Diabetes In Pregnancy ◽  
Adverse Pregnancy ◽  
In Pregnancy

Objective: Investigating for the associated factors and pregnancy outcomes of women with diabetes in pregnancy. Materials and methods: A cohort study in two groups of pregnant women with pre-gestational diabetes and women with GDM who were managed and finished of pregnancy in the Department of Obstetrics and Gynecology, Hospital of Hue University of Medicine and Pharmacy Hospital from January to December 2017. Results: The pregnant women with pre-gestational diabetes have 78.13% previous birth of infant weighing 3500 gram or more and 46.88% preeclampsia - eclampsia. The rate of treatment with Insulin ranged from 78.13% in pregnant women with pre-gestational diabetes to 12.5% in women with GDM (p<0.05). Caesarean sectionc has high rate in both groups. The pregnant women with pre-gestational diabetes have high risk of adverse pregnancy outcomes: macrosomia ≥ 3500 gram, hyperbilirubinemia, fetal demise, preeclampsia - eclampsia, postpartum haemorrhage; and average blood glucose at delivery is 7.06 mmol/L. Conclusions: The management of women with diabetes in pregnancy remains challenging. The hight rate of pregnant women with pre-gestational diabetes has treatment with Insulin and adverse pregnancy outcomes. Key words: Diabetes, Gestational Diabetes Mellitus (GDM)

scholarly journals Early Pregnancy Vitamin D Binding Protein Is Independently Associated with the Development of Gestational Diabetes: A Retrospective Cohort Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2186
Author(s):  
Melinda Fernando ◽  
Stacey J. Ellery ◽  
Deborah de Guingand ◽  
Clara Marquina ◽  
Siew Lim ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Vitamin D Metabolites ◽  
Vitamin D Binding Protein ◽  
Adverse Pregnancy ◽  
Length Of Gestation

Background: Vitamin D-binding protein (VDBP) has been implicated in several adverse pregnancy outcomes either directly or indirectly via influencing the concentrations of biologically active vitamin D metabolites. However, human studies exploring these metabolites in pregnancy remain sparse. Here, we examine whether VDBP and total, free, and bioavailable 25-hydroxyvitamin D (25(OH)D) metabolites in early pregnancy are associated with subsequent adverse pregnancy outcomes. Methods: We conducted a retrospective analysis of 304 pregnant women in early pregnancy (<20 weeks gestation). The demographic characteristics, anthropometric data, and total 25(OH)D were measured and plasma or serum samples were collected and bio-banked. Using these samples, we measured VDBP (polyclonal ELISA) and albumin (automated colorimetry), and calculated free and bioavailable 25(OH)D using validated formulae. Pregnancy outcomes were derived from scanned medical records. Regression models were used to analyse the relationships between vitamin D metabolites in early pregnancy and subsequent pregnancy outcomes (gestational diabetes mellitus (GDM), pre-eclampsia, preterm birth), with adjustment for predetermined clinically relevant maternal factors including age, body mass index (BMI), and ethnicity. Results: Lower VDBP concentrations were associated with higher glucose levels and a greater likelihood of developing GDM at 26–28 weeks gestation (odds ratio [OR] (95% CI) = 0.98 (0.97,0.99), p = 0.015). This finding remained significant after adjustment for maternal covariates including age, BMI, and ethnicity (β = −0.003, p = 0.03). Lower total, free and bioavailable 25(OH)D, but not VDBP, were associated with a shorter length of gestation, but only the relationship with total 25(OH)D remained significant after adjustment for the above maternal covariates (β = 0.02, p = 0.006). Conclusions: This is the first study to examine VDBP, and total, free and bioavailable 25(OH)D in relation to pregnancy outcomes in a well characterised multi-ethnic cohort of pregnant women. Our findings show that VDBP and total 25(OH)D are associated with GDM and length of gestation, respectively; however, further investigations using large-scale prospective studies are needed to confirm our findings.

scholarly journals The association between soy intake and risk of gestational diabetes mellitus: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wang ◽  
Biru Luo ◽  
Jie Xiang
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background The association between soy intake and adverse pregnancy outcomes remains unclear. The objectives of this study were to investigate the soy consumption of pregnant women in the second trimester and explore the prospective association between soy intake and the risk of adverse pregnancy outcomes. Methods Pregnant women between 13 and 24 weeks of gestation were recruited at a women’s and children’s hospital in southwest China from June to December 2019. Dietary intakes in the middle trimester were assessed by a semi-quantitative food frequency questionnaire. Participants were divided into the insufficient group (< 40 g/day) and the control group (≥40 g/day) according to daily soy consumption. Participants were followed up until delivery. Pregnancy outcomes including gestational diabetes mellitus (GDM), cesarean section, and macrosomia were obtained. Multiple logistic regression was used to analyze the association between soy intake and risk of adverse pregnancy outcomes. Sociodemographic information, histories of diseases, and duration of physical activities were obtained and used for covariate adjustments. Results A total of 224 participants were included in this study, of which identified 36 (16.1%) cases of GDM, and 120 (53.6%) cases of cesarean section. More than half (125, 55.8%) pregnant women consumed less soy than 40 g/day. Daily soy intake less than 40 g was associated with the increased risk of GDM (OR = 2.755 95%CI 1.230-6.174, P = 0.014) and cesarean section (OR = 1.792 95%CI 1.035-3.101, P = 0.037) without adjustment for confounders such as age, pre-pregnancy body mass index, parity, daily intake of vegetables, fruits, seafood and, nuts. After adjusting for these factors, daily soy intake of less than 40 g increased 2.116-fold risk of GDM (95%CI 1.228-7.907, P = 0.017), but not with the significantly increased risk of cesarean section. Conclusion Insufficient soy intake may increase the risk of GDM, suggesting adequate soy intake may have a beneficial role in the prevention of GDM. Trial registration Registration number: ChiCTR1900023721. Date of registration: June 9, 2019.

The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

2021 ◽  
Author(s):  
Shamil D. Cooray ◽  
Jacqueline A. Boyle ◽  
Georgia Soldatos ◽  
Shakila Thangaratinam ◽  
Helena J. Teede
Keyword(s):  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Therapeutic Interventions ◽  
Clinical Prediction Model ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Individual ◽  
Personalized Risk

AbstractGestational diabetes mellitus (GDM) is common and is associated with an increased risk of adverse pregnancy outcomes. However, the prevailing one-size-fits-all approach that treats all women with GDM as having equivalent risk needs revision, given the clinical heterogeneity of GDM, the limitations of a population-based approach to risk, and the need to move beyond a glucocentric focus to address other intersecting risk factors. To address these challenges, we propose using a clinical prediction model for adverse pregnancy outcomes to guide risk-stratified approaches to treatment tailored to the individual needs of women with GDM. This will allow preventative and therapeutic interventions to be delivered to those who will maximally benefit, sparing expense, and harm for those at a lower risk.

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