Pre-pregnancy obesity, gestational diabetes or gestational weight gain: Which is the strongest predictor of pregnancy outcomes?

Abstract

AIMS:

Both obesity and gestational diabetes (GDM) are risk factors for adverse pregnancy outcomes. The aim of our study is to ascertain the independent role of prepregnancy BMI (pp-BMI), gestational weight gain (GWG), and GDM on pregnancy outcomes.

METHODS:

We analyzed data of 1198 pregnant women, who underwent selective screening for GDM. Data on pregnancy outcomes was collected from hospital discharge records.

RESULTS:

Cesarean section (CS) was comparable in GDM and NGT women. Prevalence of fetal macrosomia was 5.9%, with no difference between GDM and normal glucose tolerance (NGT), neonatal hyperbilirubinemia were more frequent in newborns of GDM women (63.3% vs. 52.2%; p < 0.01). Offspring of women with excessive GWG weighed more than those of women with regular GWG (3405 ± 510 g vs. 3287 ± 524 g; p < 0.01). On a logistic regression analysis, GWG was an independent risk factor for macrosomia (OR 1.08, 95% CI 1.02-1.13; p < 0.01) and delivery at a gestational age <37 weeks (OR 0.29, 95% CI 0.16-0.53; p < 0.0001). GDM and pp-BMI were not independent risk factors for adverse outcomes in this cohort.

CONCLUSIONS:

GWG rather than GDM is associated with adverse pregnancy outcomes. These findings call for an early education and implementation of a healthy lifestyle in women planning a pregnancy.

• Authors: Cristina Bianchi, Giovanni de Gennaro, Matilde Romano, Michele Aragona, Lorella Battini, Stefano Del Prato, Alessandra Bertolotto
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 144 Pg. 286-293 (Oct 2018) ISSN: 1872-8227 [Electronic] Ireland
• PMID: 30189224 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Topics

• Adult
• Body Mass Index
• Diabetes, Gestational (physiopathology)
• Female
• Fetal Macrosomia (epidemiology)
• Gestational Age
• Humans
• Infant, Newborn
• Italy (epidemiology)
• Male
• Obesity (physiopathology)
• Pregnancy
• Pregnancy Outcome
• Prevalence
• Retrospective Studies
• Risk Factors
• Weight Gain
• Young Adult