OBJECTIVES: We sought to determine the impact of maternal weight gain on fetal growth in gestational diabetes (GDM) in relation to treatment modality, body mass index (BMI) and glycemic control. STUDY DESIGN: Two thousand four hundred fifty-four GDMs were evaluated. Obesity was defined as BMI >29; good glycemic control ≤ 100 mg/dl; maternal age < and >30 years; parity ± 1; large for gestational age (LGA) >90th percentile and small for gestational age (SGA) <10th percentile. RESULTS: SGA rates were similar in all groups. Obese/overweight diet-treated women in glycemic control showed a four-fold higher rate of LGA compared to insulin-treated women. A 36-lb weight gain in insulin-treated patients had a six-fold higher risk. In poor glycemic control, LGA rates were higher in all BMI/weight gain categories. Logistic regressions for LGA/SGA revealed that level of glycemia, weight gain, parity, obesity and treatment (for LGA only) were significant. CONCLUSION: Different thresholds used for different maternal BMI categories in addition to the achievement of glycemic control and pharmacological therapy will enhance pregnancy outcome.
OBJECTIVES: We sought to determine the impact of maternal weight gain on fetal growth in gestational diabetes (GDM) in relation to treatment modality, body mass index (BMI) and glycemic control. STUDY DESIGN: Two thousand four hundred fifty-four GDMs were evaluated. Obesity was defined as BMI >29; good glycemic control ≤ 100 mg/dl; maternal age < and >30 years; parity ± 1; large for gestational age (LGA) >90th percentile and small for gestational age (SGA) <10th percentile. RESULTS: SGA rates were similar in all groups. Obese/overweight diet-treated women in glycemic control showed a four-fold higher rate of LGA compared to insulin-treated women. A 36-lb weight gain in insulin-treated patients had a six-fold higher risk. In poor glycemic control, LGA rates were higher in all BMI/weight gain categories. Logistic regressions for LGA/SGA revealed that level of glycemia, weight gain, parity, obesity and treatment (for LGA only) were significant. CONCLUSION: Different thresholds used for different maternal BMI categories in addition to the achievement of glycemic control and pharmacological therapy will enhance pregnancy outcome.
Authors: Junhong Leng; Weiqin Li; Shuang Zhang; Huikun Liu; Leishen Wang; Gongshu Liu; Nan Li; Leanne M Redman; Andrea A Baccarelli; Lifang Hou; Gang Hu Journal: PLoS One Date: 2015-06-22 Impact factor: 3.240
Authors: Raffael Ott; Jens H Stupin; Andrea Loui; Elisabeth Eilers; Kerstin Melchior; Rebecca C Rancourt; Karen Schellong; Thomas Ziska; Joachim W Dudenhausen; Wolfgang Henrich; Andreas Plagemann Journal: BMC Pregnancy Childbirth Date: 2018-06-20 Impact factor: 3.007