Gestational diabetes

Abstract

Background:Weight gain during pregnancy reflects the mother's nutritional status. However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM). This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM.Methods:A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016. Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records. Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression.Results:In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG. Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50–3.52, P < 0.001), large for gestational age (aOR 2.06, 95% CI 1.44–2.93, P < 0.001), small for gestational age (aOR 0.49, 95% CI 0.25–0.97, P = 0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20–12.00, P = 0.023), preterm birth (aOR 0.45, 95% CI 0.21–0.96, P = 0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13–1.87, P = 0.004). Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96–6.37, P < 0.001).Conclusions:Both excessive and insufficient weight gain require attention in women with GDM. Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes.

Physical Exercise is Associated with Glycemic Control among Women with Gestational Diabetes Mellitus: Findings from a Prospective Cohort in Shanghai, China

“…In this study, BMI before pregnancy was classified as <18.5, 18.5-24.9, 25-29.9, and ≥ 30 [7,9]. Weight gain (kg) in gestation was calculated as pre-birth body weight minus pre-pregnancy body weight.…”

“… 5 , 6 In China, the prevalence of GDM has recently increased from 14.7% to 20.9%, which represents an epidemic proportion. 2 , 7 In recent years, lifestyle, imbalanced diet, and a growing number of women with advanced maternal age achieving second pregnancy due to the ‘two-child policy in China’ may increase the incidence of GDM, which has become a serious burden on public health in China. 5 …”

“…5,6 In China, the prevalence of GDM has recently increased from 14.7% to 20.9%, which represents an epidemic proportion. 2,7 In recent years, lifestyle, imbalanced diet, and a growing number of women with advanced maternal age achieving second pregnancy due to the 'two-child policy in China' may increase the incidence of GDM, which has become a serious burden on public health in China. 5 The successful management of GDM involving tight glycemic control, 8 and achieving optimal glycemic control reduces the risk of premature rupture of membranes, preeclampsia, fetal macrosomia, preterm birth, cesarean delivery, 7,9 and diabetes following delivery as well.…”

“…2,7 In recent years, lifestyle, imbalanced diet, and a growing number of women with advanced maternal age achieving second pregnancy due to the 'two-child policy in China' may increase the incidence of GDM, which has become a serious burden on public health in China. 5 The successful management of GDM involving tight glycemic control, 8 and achieving optimal glycemic control reduces the risk of premature rupture of membranes, preeclampsia, fetal macrosomia, preterm birth, cesarean delivery, 7,9 and diabetes following delivery as well. 10 Although both balanced diet and physical exercise are recommended widely to stabilize glucose level in pregnancy, physical exercise is more acceptable than diet suggestion, due to limited nutrition intake being against the traditional perception that pregnancy is a state requiring extra nutrition and care.…”

Ganho ponderal e estado nutricional de mulheres portadoras de diabetes mellitus gestacional

“…Dentre os principais fatores de risco destacam-se: idade avançada, história familiar de DM2 em parentes de primeiro grau, síndrome de ovários policísticos e baixa estatura (Ribeiro et al, 2015;Zaman et al, 2018). Além destes, são citados na literatura, excesso de peso e ganho ponderal acima do recomendado (Braz et al, 2016;Djaković et al, 2019;Gou et al, 2019;Hantoushzadeh et al, 2016).…”