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Effects of pre-pregnancy weight on incidence of large for gestational age newborn in pregnant women with gestational diabetes mellitus

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Abstract

The aim of this study is to compare the incidence of large for gestational age (LGA) infants between gestational diabetes mellitus (GDM) women whose pre-pregnancy weight was in normal and overweight/obese category. Possible associated factors for LGA were evaluated and pregnancy outcomes were compared. A total of 272 singleton pregnant women with GDM were enrolled, 136 overweight/obese women (BMI ≥25 kg/m2) were in study group and another 136 normal weight women (BMI <25 kg/m2) were served as comparison group. Data were retrieved from medical records, including demographic data, GDM diagnosis and risks, labor and delivery data, and pregnancy outcomes. Baseline characteristics and incidence of LGA were compared between groups, and logistic regression analysis was performed in order to determine independent risk factors for LGA, adjusted for potential confounders. Baseline demographic data were comparable between groups, except that study group was significantly more likely to have excessive weight gain and more likely to need insulin treatment than control group. The rate of LGA and macrosomic infants was significantly higher in study group than in control group (p = 0.038 and 0.024, respectively). Logistic regression analysis showed that only gestational weight gain was significantly associated with LGA. Gestational weight gain less than recommendation significantly decreased the risk of LGA by 60 % (adjusted odds ratio (OR) 0.39, 95 % confidence interval (CI) 0.17–0.96, p = 0.04). On the other hand, gestational weight gain greater than recommendation significantly doubled the risk of LGA (adjusted OR 2.03, 95 % CI 1.11–3.71, p = 0.022). Gestational weight gain, but not pre-pregnancy BMI was independently associated with LGA in GDM pregnant women.

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References

  1. Cunnigham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd ed. New York: McGraw-Hil; 2010. p. 804.

    Google Scholar 

  2. Yogev Y, Visser Gerard HA. Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14:77–84.

    Article  PubMed  Google Scholar 

  3. Chauhan SP, Grobman WA, Gherman RA, et al. Suspicion and treatment of the macrosomic fetus: a review. Am J Obstet Gynecol. 2005;193:332–46.

    Article  PubMed  Google Scholar 

  4. Gregory KD, Henry OA, Ramicone E, Chan R, Platt LD. Maternal and infant complication in high and normal weight infants by method of delivery. Obstet Gynecol. 1998;92:507–13.

    CAS  PubMed  Google Scholar 

  5. The HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcome (HAPO) Study. Diabetes. 2009;58:453–9.

    Article  PubMed Central  Google Scholar 

  6. Oded L, Yogev Y, Most O, Xenakis EM. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol. 2005;1(92):989–97.

    Google Scholar 

  7. Keller JD, Lopez-Zeno JA, Dooley SL, Socol ML. Shoulder dystocia and birth trauma in gestational diabetes: a five-year experience. Am J Obstet Gynecol. 1991;165:928–30.

    Article  CAS  PubMed  Google Scholar 

  8. Okun N, Verma A, Mitchell BF, Flowerdew G. Relative importance of maternal constitutional factors and glucose intolerance of pregnancy in the development of newborn macrosomia. J Matern Fetal Med. 1997;6:285–90.

    CAS  PubMed  Google Scholar 

  9. Mello G, Parretti E, Mecacci F, et al. Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test. Eur J Endocrinol. 1997;137:27–33.

    Article  CAS  PubMed  Google Scholar 

  10. Johns K, Olynik C, Mase R, Kreisman S, Tildesley H. Gestational diabetes mellitus outcome in 394 patients. J Obstet Gynaecol Can. 2006;28:122–7.

    Article  PubMed  Google Scholar 

  11. Yogev Y, Langer O, Xenakis EM, Rosenn B. The association between glucose challenge test, obesity and pregnancy outcome in 6390 non-diabetic women. J Matern Neonatal Med. 2005;17:29–34.

    Article  Google Scholar 

  12. Siega-Riz AM, Viswanathan M, Moos MK, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009;201:339.e1-14.

    Article  PubMed  Google Scholar 

  13. Black MH, Sacks DA, Xiang AH, Lawrence JM. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care. 2013;36:56–62.

    Article  PubMed  Google Scholar 

  14. Olmos PR, Borzone GR, Olmos RI, et al. Gestation diabetes and pre-pregnancy overweight: Possible factors involved in newborn macrosomia. J Obstet Gynecol. 2012;38:208–14.

    Google Scholar 

  15. Haroush AB, Hadar E, Chen R. Maternal obesity is major risk factor for large-for-gestational-age infants in pregnancies complicated by gestational diabetes. Arch Gynecol Obstet. 2009;279:539–43.

    Article  Google Scholar 

  16. Sunsaneevithayakul P, Boriboohirunsarn D, Sutanthavibul A, et al. Risk factor based selective screening program for gestational diabetes mellitus in Siriraj Hospital: result from clinical practice guideline. J Med Assoc Thai. 2003;86:708–14.

    PubMed  Google Scholar 

  17. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144:768–73.

    Article  CAS  PubMed  Google Scholar 

  18. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US); 2009.

  19. Barnes RA, Edghill N, Mackenzie J, et al. Predictors of large and small for gestational age birthweight in offspring of women with gestational diabetes mellitus. Diabet Med. 2013;30:1040–6.

    Article  CAS  PubMed  Google Scholar 

  20. Hernandez-Rivas E, Flores-Le Roux JA, Benaiges D, et al. Gestational diabetes in a multiethnic population of Spain: clinical characteristics and perinatal outcomes. Diabetes Res Clin Pract. 2013;100:215–21.

    Article  PubMed  Google Scholar 

  21. Most O, Langer O. Gestational diabetes: maternal weight gain in relation to fetal growth, treatment modality, BMI and glycemic control. J Matern Fetal Neonatal Med. 2012;25:2458–63.

    Article  PubMed  Google Scholar 

  22. Park JE, Park S, Daily JW, Kim SH. Low gestational weight gain improves infant and maternal pregnancy outcomes in overweight and obese Korean women with gestational diabetes mellitus. Gynecol Endocrinol. 2011;27:775–81.

    Article  CAS  PubMed  Google Scholar 

  23. Ogonowski J, Miazgowski T, Czeszynska MB, Jaskot B, Kuczynska M, Celewicz Z. Factors influencing risk of macrosomia in women with gestational diabetes mellitus undergoing intensive diabetic care. Diabetes Res Clin Pract. 2008;80:405–10.

    Article  PubMed  Google Scholar 

  24. Catalano PM, McIntyre HD, Cruickshank JK, et al. The Hyperglycaemia and Adverse Pregnancy Outcomes Study—associations of GDM and obesity with pregnancy outcomes. Diabetes Care. 2012;35:780–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Conflict of interest

The study received no funding from any sources and there are no conflicts of interest of any nature at all.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Correspondence to Dittakarn Boriboonhirunsarn.

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Boriboonhirunsarn, D., Tangthasana, S. Effects of pre-pregnancy weight on incidence of large for gestational age newborn in pregnant women with gestational diabetes mellitus. Int J Diabetes Dev Ctries 37, 107–111 (2017). https://doi.org/10.1007/s13410-015-0381-5

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  • DOI: https://doi.org/10.1007/s13410-015-0381-5

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