Body mass index and gestational weight gain: relevance in gestational diabetes and outcomes - A retrospective cohort study

ABSTRACT Objective: To evaluate the influence of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on blood glucose levels at diagnosis of gestational diabetes mellitus (GDM) and obstetric/neonatal outcomes. Subjects and methods: Retrospective cohort study including 462 women with GDM and singleton pregnancy delivered in our institution between January 2015 and June 2018 and grouped according to BMI/GWG. Results: The diagnosis of GDM was more likely to be established in the 1st trimester (T) in women with obesity than in normal-weight (55.8% vs 53.7%, p = 0.008). BMI positively and significantly correlated with fasting plasma glucose (FPG) levels in the 1stT (rs = 0.213, p = 0.001) and 2ndT (rs = 0.210, p = 0.001). Excessive GWG occurred in 44.9% women with overweight and in 40.2% with obesity (p < 0.001). From women with obesity, 65.1% required pharmacological treatment (p < 0.001). Gestational hypertension (GH) was more frequent in women with obesity (p = 0.016). During follow-up, 132 cesareans were performed, the majority in mothers with obesity (p = 0.008). Of the 17 large-for-gestational-age (LGA) birthweight delivered, respectively 6 and 9 were offsprings of women with overweight and obesity (p = 0.019). Maternal BMI had a predictive value only for macrosomia [aOR 1.177 (1.006-1.376), p = 0.041]. BMI and GWG positively correlated with birthweight (rs = 0.132, p = 0.005; rs = 0.188, p = 0.005). Conclusion: Maternal obesity is related with a major probability of diagnosis of GDM in 1stT, fasting hyperglycemia in 2ndT and a more frequent need for pharmacological therapy. Pre-gestational obesity is associated with GH, cesarean delivery and fetal macrosomia.

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Autores principales:	Rosinha,Patrícia Mendonça Oliveira, Dantas,Rosa Alexandra Barbosa, Alves,Márcia Inês Paiva, Azevedo,Teresa Cristina Maia Ferreira, Inácio,Isabel Maria Ramos, Ferreira,Sara Gabriela Esteves, Pedrosa,Carla Alexandra Vieira, Ferreira,Marília Sousa, Sousa,Isabel Maria Albuquerque, Costa,Joana Guimarães Martins da
Formato:	Digital revista
Idioma:	English
Publicado:	Sociedade Brasileira de Endocrinologia e Metabologia 2022
Acceso en línea:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972022000200261
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