The Independent Effects Of Maternal Obesity And Gestational Diabetes On The Pregnancy Outcomes | 36249
Journal of Obesity & Weight Loss Therapy
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Obesity and gestational diabetes (GDM) in pregnancy are recognized risk factors for adverse outcomes, including cesarean
section (CS), macrosomia and preeclampsia. The aim of this study was to investigate the independent effect of GDM and
obesity on the adverse pregnancy outcomes at term. A retrospective cohort of postpartum women, in King Khalid University
Hospital, were stratified according to body mass index (obese ≥30 kg/m2, non-obese <30 kg/m2) and the results of GDM
screening into the following groups, women with no obesity and no GDM (reference group), women with no obesity but with
GDM, women with obesity but no GDM and women with both GDM and obesity. Adverse pregnancy outcomes included high
birth weight, macrosomia, CS delivery and preeclampsia. Multiple logistic regression used to examine independent associations
of GDM and obesity with macrosomia and CS. 2701 women were included, 44% of them were obese and 15% had GDM. 63%
of the women with GDM were obese. There was significant increase in the percentage of macrosomia, P<0.001, high birth
weight, P<0.001, CS, P<0.001 and preeclampsia, P<0.001 in women with GDM and obesity compared to the reference group.
Obesity increased the estimated risk of CS delivery, odds ratio (OR) 2.16, confidence intervals (CI) 1.74-2.67. The combination
of GDM and obesity increased the risk of macrosomia OR 3.45, CI 2.05-5.81 and the risk of CS delivery OR 2.26, CI 1.65-3.11.
In conclusion maternal obesity and GDM were independently associated with adverse pregnancy outcomes. The combination
of both conditions further increase the risk.
Hayfaa A Wahabi is an Associate Professor in the Chair of Evidence-based Healthcare and Knowledge Translation, King Saud University (Riyadh, Saudi Arabia). She is a fellow of the Royal College of Obstetrician and Gynaecologists of England and holds a PhD in maternal epidemiology from Warwick University. She has published more than 20 papers in high impact journals including systematic reviews which influenced policy and practice in maternity services all over the world. She is a member of editorial board of many reputable journals.