OBJECTIVE: To determine the impact of obesity on pregnancies complicated by insulin resistance. STUDY DESIGN: Secondary analysis of prospective cohort of women with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (DM). The exclusion criteria were type 1 DM, multiple gestation, fetal anomalies, unknown prepregnancy, and body mass index (BMI). Primary maternal outcome was a composite of any of the following: severe preeclampsia, eclampsia, third- to fourth-degree laceration, readmission, wound infection, or antepartum hospitalization. Primary neonatal outcome was a composite of any of the following: hypoglycemia, preterm delivery, admission to level 3 nursery, oxygen requirement > 6 hours after birth, shoulder dystocia, 5-minute Apgar ≤3, cord pH < 7.0, and cord base excess < -12 mmol/L. Obese women (BMI ≥30.0 kg/m(2)) were compared with nonobese women (BMI < 30.0 kg/m(2)). RESULTS: Of 356 subjects with DM, 233 (66%) were obese. Obese women were not at further increased risk of the composite maternal outcome (adjusted odds ratio [AOR] = 0.68, 95% confidence interval [CI] = 0.43-1.09), the composite neonatal outcome (AOR = 0.76, 95% CI = 0.48-1.21), or cesarean (58.8 vs. 52.9%, p = 0.28, AOR = 1.47, 95% CI = 0.91-2.39). CONCLUSION: We did not find evidence that obesity worsened pregnancy outcomes in women with GDM and type 2 DM, suggesting that obese women may not require more stringent antepartum treatment strategies. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To determine the impact of obesity on pregnancies complicated by insulin resistance. STUDY DESIGN: Secondary analysis of prospective cohort of women with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (DM). The exclusion criteria were type 1 DM, multiple gestation, fetal anomalies, unknown prepregnancy, and body mass index (BMI). Primary maternal outcome was a composite of any of the following: severe preeclampsia, eclampsia, third- to fourth-degree laceration, readmission, wound infection, or antepartum hospitalization. Primary neonatal outcome was a composite of any of the following: hypoglycemia, preterm delivery, admission to level 3 nursery, oxygen requirement > 6 hours after birth, shoulder dystocia, 5-minute Apgar ≤3, cord pH < 7.0, and cord base excess < -12 mmol/L. Obesewomen (BMI ≥30.0 kg/m(2)) were compared with nonobese women (BMI < 30.0 kg/m(2)). RESULTS: Of 356 subjects with DM, 233 (66%) were obese. Obesewomen were not at further increased risk of the composite maternal outcome (adjusted odds ratio [AOR] = 0.68, 95% confidence interval [CI] = 0.43-1.09), the composite neonatal outcome (AOR = 0.76, 95% CI = 0.48-1.21), or cesarean (58.8 vs. 52.9%, p = 0.28, AOR = 1.47, 95% CI = 0.91-2.39). CONCLUSION: We did not find evidence that obesity worsened pregnancy outcomes in women with GDM and type 2 DM, suggesting that obesewomen may not require more stringent antepartum treatment strategies. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Patrick M Catalano; H David McIntyre; J Kennedy Cruickshank; David R McCance; Alan R Dyer; Boyd E Metzger; Lynn P Lowe; Elisabeth R Trimble; Donald R Coustan; David R Hadden; Bengt Persson; Moshe Hod; Jeremy J N Oats Journal: Diabetes Care Date: 2012-02-22 Impact factor: 19.112
Authors: F Pardo; L Silva; T Sáez; R Salsoso; J Gutiérrez; C Sanhueza; A Leiva; L Sobrevia Journal: Int J Obes (Lond) Date: 2015-04-14 Impact factor: 5.095