The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism
Abstract Objectives The gestational weight gain (GWG) and hyperglycemia are two key factors affecting adverse pregnancy outcomes among women with gestational diabetes mellitus (GDM). We aimed to investigate the combinatorial effect of abnormal glucose metabolism and GWG on adverse outcomes in GDM. M...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2023-07-01
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| Series: | Nutrition & Diabetes |
| Online Access: | https://doi.org/10.1038/s41387-023-00239-1 |
| _version_ | 1797784367490138112 |
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| author | Qi Wu Yunyan Chen Hao Ma Tao Zhou Ying Hu Zhaoxia Liang Danqing Chen |
| author_facet | Qi Wu Yunyan Chen Hao Ma Tao Zhou Ying Hu Zhaoxia Liang Danqing Chen |
| author_sort | Qi Wu |
| collection | DOAJ |
| description | Abstract Objectives The gestational weight gain (GWG) and hyperglycemia are two key factors affecting adverse pregnancy outcomes among women with gestational diabetes mellitus (GDM). We aimed to investigate the combinatorial effect of abnormal glucose metabolism and GWG on adverse outcomes in GDM. Methods This retrospective cohort study included 2611 pregnant women with GDM in Women’s Hospital School of Medicine Zhejiang University. Bases on the OGTT glucose levels, we categorized the GDM cohort into three subgroups: impaired fasting glucose (IFG) group, impaired glucose tolerance (IGT) group, and combined impaired glucose (IFG&IGT) group. Results Among pregnant women with IGT, insufficient GWG (IGWG) was an independent protective factor for pregnancy-induced hypertension syndrome (PIH) (aOR 0.55, 95% CI 0.32-0.95), macrosomia (0.38, 0.19-0.74) and large for gestational age (0.45, 0.32-0.62), as well as an independent risk factor for low birth weight infants (2.29, 1.24-4.22) and small for gestational age (1.94, 1.17-3.19); and excessive GWG (EGWG) was related to increased risks of PIH (1.68, 1.12-2.52), preterm delivery (1.82, 1.28-2.58), postpartum hemorrhage (1.85, 1.05–3.28), cesarean delivery (1.84, 1.38-2.46) and low body weight infants (2.36, 1.33-4.20). Moreover, EGWG was positively associated with PIH (3.27, 1.09–9.80) in the IFG group. But there were no significant associations between either IGWG or EGWG and any pregnancy outcomes in women with combined IFG&IGT. Conclusions The relationships between GWG and adverse outcomes were modified by abnormal glucose metabolism in women with GDM. Our results suggest that more specific GWG recommendations according to their metabolic state are needed for GDM. |
| first_indexed | 2024-03-13T00:38:53Z |
| format | Article |
| id | doaj.art-9701642d2b164be4b5ac7648803fb94a |
| institution | Directory Open Access Journal |
| issn | 2044-4052 |
| language | English |
| last_indexed | 2024-03-13T00:38:53Z |
| publishDate | 2023-07-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Nutrition & Diabetes |
| spelling | doaj.art-9701642d2b164be4b5ac7648803fb94a2023-07-09T11:28:29ZengNature Publishing GroupNutrition & Diabetes2044-40522023-07-011311810.1038/s41387-023-00239-1The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolismQi Wu0Yunyan Chen1Hao Ma2Tao Zhou3Ying Hu4Zhaoxia Liang5Danqing Chen6Obstetrical Department, Women’s Hospital, School of Medicine, Zhejiang UniversityObstetrical Department, Women’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Epidemiology, School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Epidemiology, School of Public Health and Tropical Medicine, Tulane UniversityObstetrical Department, Women’s Hospital, School of Medicine, Zhejiang UniversityObstetrical Department, Women’s Hospital, School of Medicine, Zhejiang UniversityObstetrical Department, Women’s Hospital, School of Medicine, Zhejiang UniversityAbstract Objectives The gestational weight gain (GWG) and hyperglycemia are two key factors affecting adverse pregnancy outcomes among women with gestational diabetes mellitus (GDM). We aimed to investigate the combinatorial effect of abnormal glucose metabolism and GWG on adverse outcomes in GDM. Methods This retrospective cohort study included 2611 pregnant women with GDM in Women’s Hospital School of Medicine Zhejiang University. Bases on the OGTT glucose levels, we categorized the GDM cohort into three subgroups: impaired fasting glucose (IFG) group, impaired glucose tolerance (IGT) group, and combined impaired glucose (IFG&IGT) group. Results Among pregnant women with IGT, insufficient GWG (IGWG) was an independent protective factor for pregnancy-induced hypertension syndrome (PIH) (aOR 0.55, 95% CI 0.32-0.95), macrosomia (0.38, 0.19-0.74) and large for gestational age (0.45, 0.32-0.62), as well as an independent risk factor for low birth weight infants (2.29, 1.24-4.22) and small for gestational age (1.94, 1.17-3.19); and excessive GWG (EGWG) was related to increased risks of PIH (1.68, 1.12-2.52), preterm delivery (1.82, 1.28-2.58), postpartum hemorrhage (1.85, 1.05–3.28), cesarean delivery (1.84, 1.38-2.46) and low body weight infants (2.36, 1.33-4.20). Moreover, EGWG was positively associated with PIH (3.27, 1.09–9.80) in the IFG group. But there were no significant associations between either IGWG or EGWG and any pregnancy outcomes in women with combined IFG&IGT. Conclusions The relationships between GWG and adverse outcomes were modified by abnormal glucose metabolism in women with GDM. Our results suggest that more specific GWG recommendations according to their metabolic state are needed for GDM.https://doi.org/10.1038/s41387-023-00239-1 |
| spellingShingle | Qi Wu Yunyan Chen Hao Ma Tao Zhou Ying Hu Zhaoxia Liang Danqing Chen The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism Nutrition & Diabetes |
| title | The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| title_full | The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| title_fullStr | The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| title_full_unstemmed | The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| title_short | The heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| title_sort | heterogeneous associations between gestational weight gain and adverse pregnancy outcomes in gestational diabetes mellitus according to abnormal glucose metabolism |
| url | https://doi.org/10.1038/s41387-023-00239-1 |
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