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Gestational diabetes and pre-pregnancy overweight: possible factors involved in newborn macrosomia.
J Obstet Gynaecol Res. 2012 Jan; 38(1):208-14.JO

Abstract

AIM

Good glycemic control in gestational diabetes mellitus (GDM) seems not to be enough to prevent macrosomia (large-for-gestational-age newborns). In GDM pregnancies we studied the effects of glycemic control (as glycosylated hemoglobin [HbA1c]), pre-pregnancy body mass index (PP-BMI) and gestational weight gain per week (GWG-W) on the frequency of macrosomia.

METHODS

We studied 251 GDM pregnancies, divided into two groups: PP-BMI<25.0kg/m(2) (the non-overweight group; n=125), and PP-BMI≥25.0kg/m(2) (the overweight group; n=126). A newborn weight Z-score>1.28 was considered large-for-gestational-age. Statistical analysis was carried out using the Student's t-test and χ(2) -test, receiver-operator characteristic curves and linear and binary logistic regressions.

RESULTS

Prevalence of macrosomia was 14.9% among GDM (n=202/251, 88.4%) with good glycemic control (mean HbA1c<6.0%), and 28.1% in those with mean HbA1c≥6.0% (n=49/251, P<0.025). Macrosomia rates were 10.4% in the non-overweight group and 24.6% in the overweight group (P=0.00308), notwithstanding both having similar mean HbA1c (5.48±0.065 and 5.65±0.079%, P=0.269), and similar GWG-W (0.292±0.017 and 0.240±0.021kg/week, P=0.077). Binary logistic regressions showed that PP-BMI (P=0.012) and mean HbA1c (P=0.048), but not GWG-W (P=0.477), explained macrosomia.

CONCLUSIONS

Good glycemic control in GDM patients was not enough to reduce macrosomia to acceptable limits (<10% of newborns). PP-BMI and mean HbA1c (but not GWG-W) were significant predictors of macrosomia. Thus, without ceasing in our efforts to improve glycemic control during GDM pregnancies, patients with overweight/obesity need to be treated prior to becoming pregnant.

Authors+Show Affiliations

Departments of Nutrition, Diabetes and Metabolism, College of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile. polmos@med.puc.clNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22070342

Citation

Olmos, Pablo Roberto, et al. "Gestational Diabetes and Pre-pregnancy Overweight: Possible Factors Involved in Newborn Macrosomia." The Journal of Obstetrics and Gynaecology Research, vol. 38, no. 1, 2012, pp. 208-14.
Olmos PR, Borzone GR, Olmos RI, et al. Gestational diabetes and pre-pregnancy overweight: possible factors involved in newborn macrosomia. J Obstet Gynaecol Res. 2012;38(1):208-14.
Olmos, P. R., Borzone, G. R., Olmos, R. I., Valencia, C. N., Bravo, F. A., Hodgson, M. I., Belmar, C. G., Poblete, J. A., Escalona, M. O., & Gómez, B. (2012). Gestational diabetes and pre-pregnancy overweight: possible factors involved in newborn macrosomia. The Journal of Obstetrics and Gynaecology Research, 38(1), 208-14. https://doi.org/10.1111/j.1447-0756.2011.01681.x
Olmos PR, et al. Gestational Diabetes and Pre-pregnancy Overweight: Possible Factors Involved in Newborn Macrosomia. J Obstet Gynaecol Res. 2012;38(1):208-14. PubMed PMID: 22070342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gestational diabetes and pre-pregnancy overweight: possible factors involved in newborn macrosomia. AU - Olmos,Pablo Roberto, AU - Borzone,Gisella Rosa, AU - Olmos,Roberto Ignacio, AU - Valencia,Claudio Nicolás, AU - Bravo,Felipe Andrés, AU - Hodgson,María Isabel, AU - Belmar,Cristián Gastón, AU - Poblete,José Andrés, AU - Escalona,Manuel Orlando, AU - Gómez,Bernardita, Y1 - 2011/11/09/ PY - 2011/11/11/entrez PY - 2011/11/11/pubmed PY - 2012/6/7/medline SP - 208 EP - 14 JF - The journal of obstetrics and gynaecology research JO - J. Obstet. Gynaecol. Res. VL - 38 IS - 1 N2 - AIM: Good glycemic control in gestational diabetes mellitus (GDM) seems not to be enough to prevent macrosomia (large-for-gestational-age newborns). In GDM pregnancies we studied the effects of glycemic control (as glycosylated hemoglobin [HbA1c]), pre-pregnancy body mass index (PP-BMI) and gestational weight gain per week (GWG-W) on the frequency of macrosomia. METHODS: We studied 251 GDM pregnancies, divided into two groups: PP-BMI<25.0kg/m(2) (the non-overweight group; n=125), and PP-BMI≥25.0kg/m(2) (the overweight group; n=126). A newborn weight Z-score>1.28 was considered large-for-gestational-age. Statistical analysis was carried out using the Student's t-test and χ(2) -test, receiver-operator characteristic curves and linear and binary logistic regressions. RESULTS: Prevalence of macrosomia was 14.9% among GDM (n=202/251, 88.4%) with good glycemic control (mean HbA1c<6.0%), and 28.1% in those with mean HbA1c≥6.0% (n=49/251, P<0.025). Macrosomia rates were 10.4% in the non-overweight group and 24.6% in the overweight group (P=0.00308), notwithstanding both having similar mean HbA1c (5.48±0.065 and 5.65±0.079%, P=0.269), and similar GWG-W (0.292±0.017 and 0.240±0.021kg/week, P=0.077). Binary logistic regressions showed that PP-BMI (P=0.012) and mean HbA1c (P=0.048), but not GWG-W (P=0.477), explained macrosomia. CONCLUSIONS: Good glycemic control in GDM patients was not enough to reduce macrosomia to acceptable limits (<10% of newborns). PP-BMI and mean HbA1c (but not GWG-W) were significant predictors of macrosomia. Thus, without ceasing in our efforts to improve glycemic control during GDM pregnancies, patients with overweight/obesity need to be treated prior to becoming pregnant. SN - 1447-0756 UR - https://www.unboundmedicine.com/medline/citation/22070342/Gestational_diabetes_and_pre_pregnancy_overweight:_possible_factors_involved_in_newborn_macrosomia_ L2 - https://doi.org/10.1111/j.1447-0756.2011.01681.x DB - PRIME DP - Unbound Medicine ER -