Contributing factors to perinatal outcome in pregnancies with gestational diabetes : What matters most? A retrospective analysis

GND
1027071457
ORCID
0000-0002-2903-391X
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany, friederike.weschenfelder@med.uni-jena.de
Weschenfelder, Friederike;
GND
122839024X
ORCID
0000-0002-7416-7589
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany, friederike.hein@hotmail.com
Hein, Friederike;
GND
1216191093
Affiliation
Institute of Medical Statistics and Computer Science, University Hospital Jena, Friedrich Schiller University, 07747 Jena, Germany, thomas.lehmann@med.uni-jena.de
Lehmann, Thomas;
GND
123039762
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany, ekkehard.schleussner@med.uni-jena.de
Schleußner, Ekkehard;
GND
11819187X
ORCID
0000-0003-3553-4056
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany, tanja.groten@med.uni-jena.de
Groten, Tanja

The aim of diabetes care of pregnant women with gestational diabetes mellitus (GDM) is to attain pregnancy outcomes including rates of large-for-gestational-age (LGA) newborns, preeclampsia, C-sections (CS) and other neonatal outcomes similar to those of the non-GDM pregnant population. Obesity and excessive weight gain during pregnancy have been shown to also impact perinatal outcome. Since GDM is frequently associated with elevated body mass index (BMI), we evaluated the impact of maternal prepregnancy BMI, development of GDM and gestational weight gain (GWG) during pregnancy on perinatal outcome. We compared 614 GDM patients with 5175 non-diabetic term deliveries who gave birth between 2012 and 2016. Multivariate regression analysis was used to evaluate the independent contribution of each factor on selected perinatal outcome variables. Additionally, subgroup analysis for obese (BMI ≥ 30 kg/m2 ) and non-obese women (BMI < 30 kg/m2 ) was performed. LGA was significantly influenced by BMI, GWG and GDM, while Neonatal Intensive Care Unit (NICU) admission was solely impacted by GDM. Maternal outcomes were not dependent on GDM but on GWG and prepregnancy BMI. These results remained significant in the non-obese subgroup only. Thus, GDM still affects perinatal outcomes and requires further improvement in diabetic care and patient counseling.

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