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Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study

BACKGROUND: Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify...

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Autores principales: Assaf-Balut, Carla, Familiar, Cristina, García de la Torre, Nuria, Rubio, Miguel A, Bordiú, Elena, del Valle, Laura, Lara, Miriam, Ruiz, Teresa, Ortolá, Ana, Crespo, Irene, Duran, Alejandra, Herraiz, Miguel A, Izquierdo, Nuria, Perez, Noelia, Torrejon, Maria J, Runkle, Isabelle, Montañez, Carmen, Calle-Pascual, Alfonso L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220275/
https://www.ncbi.nlm.nih.gov/pubmed/28074143
http://dx.doi.org/10.1136/bmjdrc-2016-000314
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author Assaf-Balut, Carla
Familiar, Cristina
García de la Torre, Nuria
Rubio, Miguel A
Bordiú, Elena
del Valle, Laura
Lara, Miriam
Ruiz, Teresa
Ortolá, Ana
Crespo, Irene
Duran, Alejandra
Herraiz, Miguel A
Izquierdo, Nuria
Perez, Noelia
Torrejon, Maria J
Runkle, Isabelle
Montañez, Carmen
Calle-Pascual, Alfonso L
author_facet Assaf-Balut, Carla
Familiar, Cristina
García de la Torre, Nuria
Rubio, Miguel A
Bordiú, Elena
del Valle, Laura
Lara, Miriam
Ruiz, Teresa
Ortolá, Ana
Crespo, Irene
Duran, Alejandra
Herraiz, Miguel A
Izquierdo, Nuria
Perez, Noelia
Torrejon, Maria J
Runkle, Isabelle
Montañez, Carmen
Calle-Pascual, Alfonso L
author_sort Assaf-Balut, Carla
collection PubMed
description BACKGROUND: Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify potential differences between those with and without GDM. METHODS: We carried out a post-hoc analysis of the St. Carlos Gestational Study which included 3312 pregnant women, arranged in 3 groups: normal-weight women (NWw) (2398/72.4%), overweight women (OWw) (649/19.6%) and obese women (OBw) (265/8%). OWw and OBw were grouped as EW women (EWw). We analyzed variables related to adverse pregnancy and neonatal outcomes. RESULTS: The relative risk (95% CI) for GDM was 1.82 (1.47 to 2.25; p<0.0001) for OWw, and 3.26 (2.45 to 4.35; p<0.0001) in OBw. Univariate analysis showed associations of EW to higher rates of prematurity, birth weight >90th centile, newborns admitted to neonatal intensive care unit (NICU), instrumental delivery and cesarean delivery (all p<0.005). Multivariate analysis, adjusted for parity and ethnicity, showed that EW increased the risk of prematurity, admission to NICU, cesarean and instrumental delivery, especially in EWw without GDM. NWw with GDM had a significantly lower risk of admission to NICU and cesarean delivery, compared with NWw without GDM. CONCLUSIONS: EW is detrimental for pregnancy and neonatal outcomes, and treatment of GDM contributes to lowering the risk in EWw and NWw. Applying the same lifestyle changes to all pregnant women, independent of their weight or GDM condition, could improve these outcomes.
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spelling pubmed-52202752017-01-10 Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study Assaf-Balut, Carla Familiar, Cristina García de la Torre, Nuria Rubio, Miguel A Bordiú, Elena del Valle, Laura Lara, Miriam Ruiz, Teresa Ortolá, Ana Crespo, Irene Duran, Alejandra Herraiz, Miguel A Izquierdo, Nuria Perez, Noelia Torrejon, Maria J Runkle, Isabelle Montañez, Carmen Calle-Pascual, Alfonso L BMJ Open Diabetes Res Care Clinical Care/Education/Nutrition/Psychosocial Research BACKGROUND: Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify potential differences between those with and without GDM. METHODS: We carried out a post-hoc analysis of the St. Carlos Gestational Study which included 3312 pregnant women, arranged in 3 groups: normal-weight women (NWw) (2398/72.4%), overweight women (OWw) (649/19.6%) and obese women (OBw) (265/8%). OWw and OBw were grouped as EW women (EWw). We analyzed variables related to adverse pregnancy and neonatal outcomes. RESULTS: The relative risk (95% CI) for GDM was 1.82 (1.47 to 2.25; p<0.0001) for OWw, and 3.26 (2.45 to 4.35; p<0.0001) in OBw. Univariate analysis showed associations of EW to higher rates of prematurity, birth weight >90th centile, newborns admitted to neonatal intensive care unit (NICU), instrumental delivery and cesarean delivery (all p<0.005). Multivariate analysis, adjusted for parity and ethnicity, showed that EW increased the risk of prematurity, admission to NICU, cesarean and instrumental delivery, especially in EWw without GDM. NWw with GDM had a significantly lower risk of admission to NICU and cesarean delivery, compared with NWw without GDM. CONCLUSIONS: EW is detrimental for pregnancy and neonatal outcomes, and treatment of GDM contributes to lowering the risk in EWw and NWw. Applying the same lifestyle changes to all pregnant women, independent of their weight or GDM condition, could improve these outcomes. BMJ Publishing Group 2016-12-20 /pmc/articles/PMC5220275/ /pubmed/28074143 http://dx.doi.org/10.1136/bmjdrc-2016-000314 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Clinical Care/Education/Nutrition/Psychosocial Research
Assaf-Balut, Carla
Familiar, Cristina
García de la Torre, Nuria
Rubio, Miguel A
Bordiú, Elena
del Valle, Laura
Lara, Miriam
Ruiz, Teresa
Ortolá, Ana
Crespo, Irene
Duran, Alejandra
Herraiz, Miguel A
Izquierdo, Nuria
Perez, Noelia
Torrejon, Maria J
Runkle, Isabelle
Montañez, Carmen
Calle-Pascual, Alfonso L
Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title_full Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title_fullStr Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title_full_unstemmed Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title_short Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study
title_sort gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the st. carlos gestational study
topic Clinical Care/Education/Nutrition/Psychosocial Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220275/
https://www.ncbi.nlm.nih.gov/pubmed/28074143
http://dx.doi.org/10.1136/bmjdrc-2016-000314
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