Maternal Comorbidities During Gestational Diabetes Mellitus: Obstetrical Complications, Prematurity, and Delivery

Guberman, Cristiane; Kjos, Siri L.

doi:10.1007/978-1-84882-120-0_15

Cited by 2 publications

(3 citation statements)

References 61 publications

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“…These elevated cord levels are indicative of fetal hyperinsulinemia and, hence, support the possibility of undetected maternal glucose intolerance during the pregnancy ( 16 , 17 ). In practice, in the early gestational assessment of a pregnant woman, a reported history of prior delivery of an LGA infant is considered a clinical risk factor for GDM in the current pregnancy ( 3 – 5 ). This is based on the assumption that the previous macrosomia was due to undiagnosed GDM.…”

Section: Discussionmentioning

confidence: 99%

“…In clinical practice, a previous pregnancy that resulted in the delivery of a large-for-gestational-age (LGA) infant is often considered to be a risk factor for GDM in a subsequent pregnancy ( 3 – 5 ). The rationale is that the previous LGA delivery is considered to be presumptive evidence of GDM complicating that pregnancy, whether or not it was diagnosed at the time.…”

mentioning

confidence: 99%

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Postpartum Metabolic Function in Women Delivering a Macrosomic Infant in the Absence of Gestational Diabetes Mellitus

Kew

Sermer

et al. 2011

Diabetes Care

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OBJECTIVEGestational diabetes mellitus (GDM) is associated with fetal macrosomia and maternal postpartum dysglycemia, insulin resistance, and β-cell dysfunction. Indeed, in practice, a prior pregnancy that resulted in a large-for-gestational-age (LGA) delivery is often considered presumptive evidence of GDM, whether or not it was diagnosed at the time. If this clinical assumption is correct, however, we would expect these women to exhibit postpartum metabolic dysfunction. Thus, to test this hypothesis, we assessed metabolic function during and after pregnancy in a cohort of women stratified according to the presence/absence of GDM and LGA delivery, respectively.RESEARCH DESIGN AND METHODSA total of 562 women underwent metabolic characterization, including oral glucose tolerance test (OGTT), in late pregnancy and at 3 months’ postpartum. The women were stratified into three groups: those with neither GDM nor LGA delivery (nonGDM, n = 364), those without GDM but with LGA delivery (nonGDM–LGA, n = 46), and those with GDM (n = 152).RESULTSOn logistic regression, GDM predicted postpartum glucose intolerance (OR 4.1 [95% CI 2.5–6.8]; P < 0.0001), whereas nonGDM–LGA did not (P = 0.65). At 3 months’ postpartum, the mean adjusted levels of fasting glucose and area under the glucose curve on the OGTT were significantly higher in the GDM women compared with either nonGDM or nonGDM–LGA (all P < 0.05), with no differences between the latter two groups. In a similar manner, mean adjusted insulin sensitivity (Matsuda index) and β-cell function (Insulin Secretion-Sensitivity Index-2) were lower in GDM women compared with either nonGDM or nonGDM–LGA (all P < 0.05), again with no differences between the latter two groups.CONCLUSIONSWomen with nonGDM–LGA do not exhibit postpartum metabolic dysfunction, arguing against the assumption of undiagnosed GDM in these patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Postpartum Metabolic Function in Women Delivering a Macrosomic Infant in the Absence of Gestational Diabetes Mellitus

Kew

Sermer

et al. 2011

Diabetes Care

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“…The prevalence of GDM has increased over the last 20 years and is expected to rise further as a result of the higher number of women entering pregnancy as overweight or obese [3]. Women with GDM are at increased risk of complications during pregnancy and delivery [4].…”

Section: Introductionmentioning

confidence: 99%

Pre-pregnancy dietary patterns and risk of gestational diabetes mellitus: results from an Australian population-based prospective cohort study

et al. 2015

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Aims/hypothesis We examined the associations between prepregnancy dietary patterns and the incidence of gestational diabetes mellitus (GDM) in a population-based cohort study of women of reproductive age. Methods The Australian Longitudinal Study on Women's Health included 3,853 women without pre-existing diabetes who were followed-up between 2003 and 2012. Prepregnancy dietary patterns were derived using factor analysis based on 101 food items from a validated food frequency questionnaire. GDM was self-reported and validated in a subsample. Multivariable regression models with generalised estimating equations were used to estimate RR and 95% CI. Results During 9 years follow-up, 292 GDM cases (4.4%) were documented in 6,626 pregnancies. No associations were found for the 'Fruit and low-fat dairy' and 'Cooked vegetables' patterns. The 'Meats, snacks and sweets' pattern was associated with higher GDM risk after adjustment for socioeconomic, reproductive and lifestyle factors (RR [95% CI] per SD increase in score: 1.38 [1.02, 1.86]). Further adjustment for BMI attenuated the results (1. 35 [0.98, 1.81]). In stratified analysis, the 'Meats, snacks and sweets' pattern was associated with significantly higher GDM risk in parous and obese women, and in women with lower educational qualifications. The 'Mediterranean-style' pattern was associated with lower GDM risk in the fully adjusted model (0.85 [0.76, 0.98]). Conclusions/interpretation These findings support general dietary recommendations for women of reproductive age to consume a diet rich in vegetables, whole grains, nuts and fish, and low in red and processed meats and snacks. Further prospective studies are needed to confirm these findings.

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Maternal Comorbidities During Gestational Diabetes Mellitus: Obstetrical Complications, Prematurity, and Delivery

Cited by 2 publications

References 61 publications

Postpartum Metabolic Function in Women Delivering a Macrosomic Infant in the Absence of Gestational Diabetes Mellitus

Postpartum Metabolic Function in Women Delivering a Macrosomic Infant in the Absence of Gestational Diabetes Mellitus

Pre-pregnancy dietary patterns and risk of gestational diabetes mellitus: results from an Australian population-based prospective cohort study

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