Comparison of the effects of gestational weight gain on pregnancy outcomes between non-diabetic and diabetic women
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Objective Appropriate gestational weight gain (GWG) is important in diabetic women. Current GWG guideline is for US general population, but not specific for diabetic women. We compared the effect of GWG on perinatal outcomes between diabetic and non-diabetic women. Methods Fifty two hundred and twelve women who delivered live singleton infants at Korea University Medical Center from January 2009 to December 2013 were included. One hundred twenty-nine overt diabetes women and 322 gestational diabetes women were categorized as diabetic women, and the others were categorized as none-diabetic women. 5,212 women were categorized by GWG (low 1,081; adequate 2,102; or high 2,029; according to the 2009 Institute of Medicine guidelines), and each of the 3 GWG groups was categorized into 2 groups; diabetic or non-diabetic women. And then, we compared perinatal outcomes between diabetic and non-diabetic groups. Results In each 3 GWG groups, primary cesarean section delivery, high birth weight, and large for gestational age rates were significantly higher in diabetic women than non-diabetic women. Only in adequate GWG group, preterm birth rate was significantly higher in diabetic women than non-diabetic women. Conclusion Our study shows that diabetic women had higher rates of adverse perinatal outcomes than non-diabetic women, although they achieved same GWG. It suggests that current GWG guideline may not be adequate for diabetic women, and that diabetic women may need more strict GWG control than normal population.
Abstract
Objective Appropriate gestational weight gain (GWG) is important in diabetic women. Current GWG guideline is for US general population, but not specific for diabetic women. We compared the effect of GWG on perinatal outcomes between diabetic and non-diabetic women. Methods Fifty two hundred and twelve women who delivered live singleton infants at Korea University Medical Center from January 2009 to December 2013 were included. One hundred twenty-nine overt diabetes women and 322 gestational diabetes women were categorized as diabetic women, and the others were categorized as none-diabetic women. 5,212 women were categorized by GWG (low 1,081; adequate 2,102; or high 2,029; according to the 2009 Institute of Medicine guidelines), and each of the 3 GWG groups was categorized into 2 groups; diabetic or non-diabetic women. And then, we compared perinatal outcomes between diabetic and non-diabetic groups. Results In each 3 GWG groups, primary cesarean section delivery, high birth weight, and large for gestational age rates were significantly higher in diabetic women than non-diabetic women. Only in adequate GWG group, preterm birth rate was significantly higher in diabetic women than non-diabetic women. Conclusion Our study shows that diabetic women had higher rates of adverse perinatal outcomes than non-diabetic women, although they achieved same GWG. It suggests that current GWG guideline may not be adequate for diabetic women, and that diabetic women may need more strict GWG control than normal population.
참고문헌 (23)
- Bloomgarden ZT., "Gestational diabetes mellitus and obesity", Diabetes Care, 33, pp.e60~e65 (2010)
- Viswanathan M., "Outcomes of maternal weight gain", Evid Rep Technol Assess(Full Rep), (168), pp.1~223 (2008)
- Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines, "Weight gain during pregnancy: reexamining the guidelines" (2009), National Academies Press
- Jensen DM., "Adverse pregnancy outcome in women with mild glucose intolerance : is there a clinically meaningful threshold value for glucose?", Acta Obstet Gynecol Scand, 87, pp.59~62 (2008)
- Hillier TA., "Childhood obesity and metabolic imprinting : the ongoing effects of maternal hyperglycemia", Diabetes Care, 30, pp.2287~2292 (2007)
- Jensen DM., "Clinical impact of mild carbohydrate intolerance in pregnancy : a study of 2904 nondiabetic Danish women with risk factors for gestational diabetes mellitus", Am J Obstet Gynecol, 185, pp.413~419 (2001)
- Pettitt DJ., "Gestational diabetes : infant and maternal complications of pregnancy in relation to third-trimester glucose tolerance in the Pima Indians", Diabetes Care, 3, pp.458~464 (1980)
- HAPO Study Cooperative Research Group., "Hyperglycemia and adverse pregnancy outcomes", N Engl J Med, 358, pp.1991~2002 (2008)
- Sermer M., "Impact of increasing carbohydrate intolerance on maternal-fetal outcomes in 3637 women without gestational diabetes : the Toronto Tri-Hospital Gestational Diabetes Project", Am J Obstet Gynecol, 173, pp.146~156 (1995)
- Pettitt DJ., "Long-term effects of the intrauterine environment, birth weight, and breast-feeding in Pima Indians", Diabetes Care, 21(Suppl 2), pp.B138~B141 (1998)
- Ferrara A., "Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia", Diabetologia, 50, pp.298~306 (2007)
- Dodd JM., "Screening for gestational diabetes : the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes", Aust N Z J Obstet Gynaecol, 47, pp.307~312 (2007)
- Sacks DA., "Toward universal criteria for gestational diabetes: the 75-gram glucose tolerance test in pregnancy", Am J Obstet Gynecol, 172(2 Pt 1), pp.607~614 (1995)
- Cheng YW., "Gestational weight gain and gestational diabetes mellitus : perinatal outcomes", Obstet Gynecol, 112, pp.1015~1022 (2008)
- Rasmussen KM., "New guidelines for weight gain during pregnancy : what obstetrician", gynecologists should know, 2009, pp.21, 521~526
- Catalano PM., "The hyperglycemia and adverse pregnancy outcome study : associations of GDM and obesity with pregnancy outcomes", Diabetes Care, 35, pp.780~786 (2012)
- Doubilet PM., "Improved birth weight table for neonates developed from gestations dated by early ultrasonography", J Ultrasound Med, 16, pp.241~249 (1997)
- Barnes RA., "Predictors of large and small for gestational age birthweight in offspring of women with gestational diabetes mellitus", Diabet Med, 30, pp.1040~1046 (2013)
- Horosz E., "Maternal weight gain in women with gestational diabetes mellitus", J Perinat Med, 41, pp.523~528 (2013)
- Morisset AS., "Weight gain measures in women with gestational diabetes mellitus", J Womens Health(Larchmt), 20, pp.375~380 (2011)
- Ouzounian JG., "Pre-pregnancy weight and excess weight gain are risk factors for macrosomia in women with gestational diabetes", J Perinatol, 31, pp.717~721 (2011)
- Han Z., "Low gestational weight gain and the risk of preterm birth and low birthweight : a systematic review and meta-analyses", Acta Obstet Gynecol Scand, 90, pp.935~954 (2011)
- Cedergren MI., "Optimal gestational weight gain for body mass index categories", Obstet Gynecol, 110, pp.759~764 (2007)
