Pregnancy Outcomes in Overweight and Obese Pregnant Women: A Comparison of Those With and Without Gestational Diabetes
Keywords:
obesity, overweight, gestational diabetes, adverse pregnancy outcomesAbstract
Objective: The aim was to compare pregnancy outcomes in overweight and obese pregnant women between with and without gestational diabetes mellitus (GDM), and to investigate risk factors for developing GDM in overweight and obese pregnant women at Phrachomklao Hospital.
Methods: This retrospective cross-sectional study involved collecting and analyzing data from medical records of pregnant women at Prachomklao Hospital, Phetchaburi, from October 2023 to May 2024. The study included 323 pregnant women classified as overweight or obese. Of these, 67 women (20.7%) had GDM, and 256 women (79.3%) did not.
Results: Overall prevalence of overweight and obese pregnant women was 33.3%. Women with GDM had a higher average age, a higher pre-pregnancy BMI, and gestational weight gain below the recommended range compared to the non-GDM group. Pregnancy outcomes showed that women with GDM had a significantly higher incidence of neonatal hypoglycemia (14.9% vs. 3.5%; p = .002) and birth injuries (9% vs. 2%; p = .012). Additionally, both groups of overweight and obese women showed a high cesarean section rate of 63.8%.
Conclusion: GDM in overweight and obese women significantly increases the risk of neonatal complications, particularly neonatal hypoglycemia and birth injuries. These findings highlight the importance of pre-pregnancy weight management and suggest that rigorous screening and appropriate management of GDM are essential to improving maternal and neonatal outcomes.
References
World Health Organization. Obesity and overweight [internet]. 2021 [cited 2023 December 25]; Available from: URL: https://www.who.int/en/news-room/fact-sheets/detail/obesityand-overweight
World Health Organization. Prevalence of obesity among adults [internet]. 2022 [cited 2024 March 6]; Available from: URL: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-obesity-among-adults-bmi-=-30-(crude-estimate)-(-)
Hanprasertpong T. Overweight and obesity in pregnancy. TJOG 2020;28(1):2–5. doi: 10.14456/tjog.2020.1.
Rudtanasudjatum K, Chullapram T. The association between obesity and the risk of cesarean delivery and other adverse pregnancy outcomes in singleton term pregnancies. TJOG 2008;16(3):139–45.
Linder T, Eder A, Monod C, et al. Impact of prepregnancy overweight and obesity on treatment modality and pregnancy outcome in women with gestational diabetes mellitus. Front Endocrinol (Lausanne) 2022;13:799625. doi: 10.3389/fendo.2022.799625.
Kim SY, England L, Wilson HG, et al. Percentage of gestational diabetes mellitus attributable to overweight and obesity. Am J Public Health 2010;100(6):1047–52. doi: 10.2105/AJPH.2009.172890.
Jatavan P, Luewan S, Sirilert S, et al. Trends in the prevalence of diabetes mellitus in pregnancy during the past two decades in northern Thailand. Healthcare (Basel) 2023;11(9):1315. doi: 10.3390/healthcare11091315.
ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol 2018;131(2):e49–64. doi: 10.1097/AOG.0000000000002501.
de Carvalho LS, de Oliveira AAD, Grabovski TCM, et al. Maternal prepregnancy obesity and gestational diabetes influence on adverse perinatal outcomes. Arch Endocrinol Metab 2023;67(4):e000605. doi: 10.20945/2359-3997000000605.
Yang Z, Phung H, Freebairn L, et al. Contribution of maternal overweight and obesity to the occurrence of adverse pregnancy outcomes. Aust N Z J Obstet Gynaecol 2019;59(3):367–74. doi: 10.1111/ajo.12866.
Prasit K, Boriboonhirunsarn D. Prevalence of gestational diabetes diagnosed before 24 weeks of gestation. TJOG 2022;30(6):423–31. doi: 10.14456/tjog.2022.49
Kaewsrinual S, Boriboonhirunsarn D. Risk factors for insulin therapy in gestational diabetes mellitus. TJOG 2022;30:51–9. doi: 10.14456/tjog.2022.7
Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press; 2009.
Cunningham FG, Leveno KJ, Dashe JS, et al. Williams Obstetric. 26th ed. New York: McGraw Hill; 2022.
Ngamjarus C, Pattanittum P. n4Studies: application for sample size calculation in health science research. Version 2.3. App store; 2024.
Bernard, R. Fundamentals of biostatistics. 5th ed. Duxbery: Thomson learning; 2000: 384–385.
Ngamjarus C. Sample size calculation for health science research. Khon Kaen, Thailand: Khon Kaen University Printing House; 2021.
Yang H, Xiao C, Tu J. The effect of gestational diabetes mellitus on pregnancy outcomes in advanced primiparous women: a retrospective study. Medicine (Baltimore) 2024;103(13):e37570. doi: 10.1097/MD.0000000000037570.
Wing RR, Caughey AB, Phelan S. Preconception weight loss to improve pregnancy outcomes: does the evidence justify national recommendations? Obesity (Silver Spring) 2023;31(3):594–6. doi: 10.1002/oby.23665.
Anekpornwattana S, Yangnoi J, Jareemit N, et al. Cesarean section rate in Siriraj hospital according to the Robson classification. TJOG 2020;28(1):6–15. doi.org/10.14456/tjog.2020.2
Voormolen DN, de Wit L, van Rijn BB, et al. Neonatal hypoglycemia following diet-controlled and insulin-treated gestational diabetes mellitus. Diabetes Care 2018;41(7):1385–90. doi: 10.2337/dc18-0048.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
