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Diabetologia. 2005 Sep;48(9):1736-42. Epub 2005 Jul 29.

Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia.

Author information

1
Unit of Diabetes, Endocrinology and Nutrition, University Hospital Doctor Josep Trueta, Avgda. de frança s.n., 17007, Girona, Spain. uden.wricart@htrueta.scs.es

Abstract

AIMS/HYPOTHESIS:

We evaluated diabetes-related pregnancy outcomes in a cohort of Spanish women in relation to their glucose tolerance status, prepregnancy BMI and other predictive variables.

METHODS:

The present paper is part of a prospective study to evaluate the impact of American Diabetes Association (2000) criteria in the Spanish population. A total of 9,270 pregnant women were studied and categorised as follows according to prepregnancy BMI quartiles and glucose tolerance status: (1) negative screenees; (2) false-positive screenees; (3) gestational diabetes mellitus (GDM) according to American Diabetes Association criteria only; and (4) GDM according to National Diabetes Data Group criteria (NDDG). We evaluated fetal macrosomia, Caesarean section and seven secondary outcomes as diabetes-related pregnancy outcomes. The population-attributable and population-prevented fractions of predictor variables were calculated after binary logistic regression analysis with multiple predictors.

RESULTS:

Both prepregnancy BMI and abnormal glucose tolerance categories were independent predictors of pregnancy outcomes. The upper quartile of BMI accounted for 23% of macrosomia, 9.4% of Caesarean section, 50% of pregnancy-induced hypertension and 17.6% of large-for-gestational-age newborns. In contrast, NDDG GDM accounted for 3.8% of macrosomia, 9.1% of pregnancy-induced hypertension and 3.4% of preterm births.

CONCLUSIONS/INTERPRETATION:

In terms of population impact, prepregnancy maternal BMI exhibits a much stronger influence than abnormal blood glucose tolerance on macrosomia, Caesarean section, pregnancy-induced hypertension and large-for-gestational-age newborns.

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PMID:
16052327
DOI:
10.1007/s00125-005-1877-1
[Indexed for MEDLINE]

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