The hyperglycemia and adverse Pregnancy Outcome Study Associations of GDM and obesity with pregnancy outcomes

Catalano, Patrick M., McIntyre, H. David, Cruickshank, J. Kennedy, McCance, David R., Dyer, Alan R., Metzger, Boyd E., Lowe, Lynn P., Trimble, Elisabeth R., Coustan, Donald R., Hadden, David R., Persson, Bengt, Hod, Moshe, Oats, Jeremy J.N. and HAPO Study Cooperative Research Group (2012) The hyperglycemia and adverse Pregnancy Outcome Study Associations of GDM and obesity with pregnancy outcomes. Diabetes Care, 35 4: 780-786. doi:10.2337/dc11-1790


Author Catalano, Patrick M.
McIntyre, H. David
Cruickshank, J. Kennedy
McCance, David R.
Dyer, Alan R.
Metzger, Boyd E.
Lowe, Lynn P.
Trimble, Elisabeth R.
Coustan, Donald R.
Hadden, David R.
Persson, Bengt
Hod, Moshe
Oats, Jeremy J.N.
HAPO Study Cooperative Research Group
Total Author Count Override 13
Title The hyperglycemia and adverse Pregnancy Outcome Study Associations of GDM and obesity with pregnancy outcomes
Journal name Diabetes Care   Check publisher's open access policy
ISSN 0149-5992
1935-5548
Publication date 2012-04
Sub-type Article (original research)
DOI 10.2337/dc11-1790
Volume 35
Issue 4
Start page 780
End page 786
Total pages 7
Place of publication Alexandria, VA, United States
Publisher American Diabetes Association
Collection year 2013
Language eng
Formatted abstract
OBJECTIVE
To determine associations of gestational diabetes mellitus (GDM) and obesity with adverse pregnancy outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study.

RESEARCH DESIGN AND METHODS

Participants underwent a 75-g oral glucose tolerance test (OGTT) between 24 and 32 weeks. GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. Neonatal anthropometrics and cord serum C-peptide were measured. Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide >90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. BMI was determined at the OGTT. Multiple logistic regression was used to examine associations of GDM and obesity with outcomes.

RESULTS
Mean maternal BMI was 27.7, 13.7% were obese (BMI ≥33.0 kg/m2), and GDM was diagnosed in 16.1%. Relative to non-GDM and nonobese women, odds ratio for birth weight >90th percentile for GDM alone was 2.19 (1.93–2.47), for obesity alone 1.73 (1.50–2.00), and for both GDM and obesity 3.62 (3.04–4.32). Results for primary cesarean delivery and preeclampsia and for cord C-peptide and newborn percent body fat >90th percentiles were similar. Odds for birth weight >90th percentile were progressively greater with both higher OGTT glucose and higher maternal BMI. There was a 339-g difference in birth weight for babies of obese GDM women, compared with babies of normal/underweight women (64.2% of all women) with normal glucose based on a composite OGTT measure of fasting plasma glucose and 1- and 2-h plasma glucose values (61.8% of all women).

CONCLUSIONS
Both maternal GDM and obesity are independently associated with adverse pregnancy outcomes. Their combination has a greater impact than either one alone.
Keyword Gestational Diabetes-Mellitus
Maternal Obesity
Glucose
Appropriate
Profiles
Insulin
Weight
Lipids
Women
Term
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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