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Pregnancy adverse outcomes related to pregravid body mass index and gestational weight gain, according to the presence or not of gestational diabetes mellitus: A retrospective observational study.
Diabetes Metab. 2016 Feb; 42(1):38-46.DM

Abstract

AIM

This study retrospectively evaluated the complications associated with prepregnancy overweight (OW) or obesity (OB) and gestational weight gain (GWG) in women with or without universally screened and treated gestational diabetes mellitus (GDM).

METHODS

A total of 15,551 non-Asian women without pregravid diabetes or hypertension who delivered singleton babies (2002-2010) were classified according to GDM (13.5%), pregestational body mass index (BMI; normal range: 18.5-24.9kg/m(2)), OW (26.2%), OB (13.9%; BMI≥30kg/m(2)) and GWG (<7kg: 32%; 7-11.5kg: 37%; 11.6-16kg: 23%;>16kg: 8%). Main outcome measures were large/small for gestational age (LGA/SGA), caesarean section, preeclampsia, preterm delivery and shoulder dystocia.

RESULTS

GDM was associated with more LGA babies [Odds Ratio (OR): 2.12, 95% confidence interval (CI): 1.85-2.43], caesarean section (OR: 1.49, 95% CI: 1.34-1.65) and preeclampsia (OR: 1.59, 95% CI: 1.21-2.09). OW/OB and GWG were associated with LGA infants whatever the GDM status, and with SGA babies only in women without GDM. LGA status was independently associated with GWG in women with GDM (11.6-16kg: OR: 1.74, 95% CI: 1.49-2.03 and>16kg OR: 3.42, 95% CI: 2.83-4.13 vs 7-11.5kg) and in women without GDM (OR: 2.14, 95% CI: 1.54-2.97 or OR: 2.65, 95% CI: 1.68-4.17, respectively), and with BMI only in women without GDM (OR: 1.12, 95% CI: 1.00-1.24, per 10kg/m(2)). SGA status was independently associated with OW (OR: 0.86, 95% CI: 0.77-0.98), OB (OR: 0.84, 95% CI: 0.72-0.98) and GWG<7kg (1.14, 95% CI: 1.01-1.29) only in women without GDM.

CONCLUSION

In our European cohort and considering the triumvirate of GDM, BMI and GWG, GDM was the main contributor to caesarean section and preeclampsia. OW/OB and GWG contributed to LGA and SGA infants mainly in women without GDM.

Authors+Show Affiliations

Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm, U1125 Inra, Cnam, Université Paris 13, Bobigny, France. Electronic address: emmanuel.cosson@jvr.aphp.fr.Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Obstetrics and Gynecology, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Obstetrics and Gynecology, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.Department of Obstetrics and Gynecology, Paris 13 University, Sorbonne Paris Cité, Jean-Verdier Hospital, AP-HP, Bondy, France.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

26141553

Citation

Cosson, E, et al. "Pregnancy Adverse Outcomes Related to Pregravid Body Mass Index and Gestational Weight Gain, According to the Presence or Not of Gestational Diabetes Mellitus: a Retrospective Observational Study." Diabetes & Metabolism, vol. 42, no. 1, 2016, pp. 38-46.
Cosson E, Cussac-Pillegand C, Benbara A, et al. Pregnancy adverse outcomes related to pregravid body mass index and gestational weight gain, according to the presence or not of gestational diabetes mellitus: A retrospective observational study. Diabetes Metab. 2016;42(1):38-46.
Cosson, E., Cussac-Pillegand, C., Benbara, A., Pharisien, I., Nguyen, M. T., Chiheb, S., Valensi, P., & Carbillon, L. (2016). Pregnancy adverse outcomes related to pregravid body mass index and gestational weight gain, according to the presence or not of gestational diabetes mellitus: A retrospective observational study. Diabetes & Metabolism, 42(1), 38-46. https://doi.org/10.1016/j.diabet.2015.06.001
Cosson E, et al. Pregnancy Adverse Outcomes Related to Pregravid Body Mass Index and Gestational Weight Gain, According to the Presence or Not of Gestational Diabetes Mellitus: a Retrospective Observational Study. Diabetes Metab. 2016;42(1):38-46. PubMed PMID: 26141553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pregnancy adverse outcomes related to pregravid body mass index and gestational weight gain, according to the presence or not of gestational diabetes mellitus: A retrospective observational study. AU - Cosson,E, AU - Cussac-Pillegand,C, AU - Benbara,A, AU - Pharisien,I, AU - Nguyen,M T, AU - Chiheb,S, AU - Valensi,P, AU - Carbillon,L, Y1 - 2015/07/02/ PY - 2015/02/06/received PY - 2015/06/01/revised PY - 2015/06/02/accepted PY - 2015/7/5/entrez PY - 2015/7/5/pubmed PY - 2016/11/1/medline KW - Gestational diabetes mellitus KW - Gestational weight gain KW - Obesity KW - Pregnancy KW - Prognosis SP - 38 EP - 46 JF - Diabetes & metabolism JO - Diabetes Metab VL - 42 IS - 1 N2 - AIM: This study retrospectively evaluated the complications associated with prepregnancy overweight (OW) or obesity (OB) and gestational weight gain (GWG) in women with or without universally screened and treated gestational diabetes mellitus (GDM). METHODS: A total of 15,551 non-Asian women without pregravid diabetes or hypertension who delivered singleton babies (2002-2010) were classified according to GDM (13.5%), pregestational body mass index (BMI; normal range: 18.5-24.9kg/m(2)), OW (26.2%), OB (13.9%; BMI≥30kg/m(2)) and GWG (<7kg: 32%; 7-11.5kg: 37%; 11.6-16kg: 23%;>16kg: 8%). Main outcome measures were large/small for gestational age (LGA/SGA), caesarean section, preeclampsia, preterm delivery and shoulder dystocia. RESULTS: GDM was associated with more LGA babies [Odds Ratio (OR): 2.12, 95% confidence interval (CI): 1.85-2.43], caesarean section (OR: 1.49, 95% CI: 1.34-1.65) and preeclampsia (OR: 1.59, 95% CI: 1.21-2.09). OW/OB and GWG were associated with LGA infants whatever the GDM status, and with SGA babies only in women without GDM. LGA status was independently associated with GWG in women with GDM (11.6-16kg: OR: 1.74, 95% CI: 1.49-2.03 and>16kg OR: 3.42, 95% CI: 2.83-4.13 vs 7-11.5kg) and in women without GDM (OR: 2.14, 95% CI: 1.54-2.97 or OR: 2.65, 95% CI: 1.68-4.17, respectively), and with BMI only in women without GDM (OR: 1.12, 95% CI: 1.00-1.24, per 10kg/m(2)). SGA status was independently associated with OW (OR: 0.86, 95% CI: 0.77-0.98), OB (OR: 0.84, 95% CI: 0.72-0.98) and GWG<7kg (1.14, 95% CI: 1.01-1.29) only in women without GDM. CONCLUSION: In our European cohort and considering the triumvirate of GDM, BMI and GWG, GDM was the main contributor to caesarean section and preeclampsia. OW/OB and GWG contributed to LGA and SGA infants mainly in women without GDM. SN - 1878-1780 UR - https://www.unboundmedicine.com/medline/citation/26141553/Pregnancy_adverse_outcomes_related_to_pregravid_body_mass_index_and_gestational_weight_gain_according_to_the_presence_or_not_of_gestational_diabetes_mellitus:_A_retrospective_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1262-3636(15)00087-7 DB - PRIME DP - Unbound Medicine ER -