The Effect of Maternal Obesity on Pregnancy Outcomes of Women with Gestational Diabetes Controlled with Diet Only, Glyburide, or Insulin

Joy, Saju; Roman, Ashley S.; Istwan, Niki; Rhea, Debbie; Desch, Cheryl; Stanziano, Gary; Saltzman, Daniel H.

doi:10.1055/s-0032-1314884

Cited by 11 publications

(16 citation statements)

References 11 publications

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“…We also observed higher mean birth weight, and lower mean blood glucose levels in infants of obese compared to non-obese mothers. Similar findings have been previously described [14,16,26,27]. Additionally, we found fewer SGA infants in obese mothers and, similar to our findings, Avci et al showed a higher rate of low birth weight infants in mothers with lower BMI [36].…”

Section: Discussionsupporting

confidence: 93%

“…It may be explained by chance or attributed to the small number of patients with the finding(12 patients). In our study, similar to the study by Joy et al, obese mothers who required management by insulin were older than non-obese mothers [16].…”

Section: Discussionsupporting

confidence: 90%

“…We also showed an increased risk of PIH in obese versus nonobese GDM mothers while those women managed by diet-only were more likely to have gestational hypertension. Previous researchers have consistently shown similar findings [16,[25][26][27][28][29][30][31][32]. Similar findings apply to increased prevalence of C-section in obese versus non-obese GDM mothers (50.6% vs.37.5%).…”

Section: Discussionsupporting

confidence: 76%

“…In that study the number of outcome variables were limited and the majority of variables were based on maternal report (16). In comparison, we examined multiple maternal and infantile variables and were able to collect clinical and laboratory values from the patient record.…”

Section: Discussionmentioning

confidence: 99%

“…The landmark observational study of hyperglycemia and adverse pregnancy outcome (HAPO) demonstrated increased odds of adverse pregnancy outcomes with GDM and obesity combined than either risk factor alone [14]. However, there have been conflicting literature reports regarding the synergistic effect of GDM and maternal obesity on negative fetomaternal and pregnancy outcomes [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

AT¹

2016

J Obes Weight Loss Ther

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We aimed to investigate the co-morbid effects of maternal obesity, Gestational Diabetes Mellitus (GDM), and GDM treatment options on maternal and neonatal outcomes in an inner-city population. This is a retrospective chart review study of singleton mothers with new diagnosis of GDM and their infants during a 3-year period. During the study period, 356 women ages 13-48 years with GDM gave birth to 180 males and 175 females. Majority of mothers were African American (50.8%) and had Medicaid insurance (75.8%). Obese mothers constituted 48.3% of the study population, had a higher prevalence of pregnancy induced hypertension/preeclampsia, more commonly were managed with medication and delivered by C-section than non-obese mothers. Infants of obese GDM mothers had significantly higher mean birth weight, lower mean blood glucose, and were less at risk for Small for Gestational Age (SGA). In obese mothers, heaviest mothers had infants with higher bilirubin levels than less heavy mothers. We also observed a high rate of feeding difficulty in infants of GDM mothers (12.4%). Our study emphasizes the burden of maternal obesity as a major risk factor for both maternal and neonatal poor outcomes in the context of GDM and calls for further prospective and interventional research.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

AT¹

2016

J Obes Weight Loss Ther

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The use of glyburide in the management of gestational diabetes mellitus: A meta-analysis

Zeng

Chen

et al. 2014

Advances in Medical Sciences

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Predicting failure of glyburide therapy in gestational diabetes

2016

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ObjectiveWe sought to develop a prediction model to identify women with gestational diabetes (GDM) who require insulin to achieve glycemic control.Study DesignRetrospective cohort of all singletons with GDM treated with glyburide 2007–2013. Glyburide failure was defined as reaching glyburide 20 mg/day and receiving insulin. Glyburide success was defined as any glyburide dose without insulin and >70% of visits with glycemic control. Multivariable logistic regression analysis was performed to create a prediction model.ResultsOf 360 women, 63 (17.5%) qualified as glyburide failure and 157 (43.6%) glyburide success. The final prediction model for glyburide failure included prior GDM, GDM diagnosis ≤26 weeks, 1-hour GCT ≥228 mg/dL, 3-hour GTT 1-hour value ≥221 mg/dL, ≥7 post-prandial blood sugars >120 mg/dL in the week glyburide started, and ≥1 blood sugar >200 mg/dL. The model accurately classified 81% of subjects.ConclusionsWomen with GDM who will require insulin can be identified at initiation of pharmacologic therapy.

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The Effect of Maternal Obesity on Pregnancy Outcomes of Women with Gestational Diabetes Controlled with Diet Only, Glyburide, or Insulin

Abstract: Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide.

Cited by 11 publications

References 11 publications

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

Maternal Obesity, Maternal Gestational Diabetes Mellitus, and Maternal and Neonatal Outcomes

The use of glyburide in the management of gestational diabetes mellitus: A meta-analysis

Predicting failure of glyburide therapy in gestational diabetes

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