Obesity in GDM
Luisa Ruas1, Marcia Alves1, Sandra Paiva1, Elvira Marta1,2, António Lobo1,2, Paulo Moura1,2 & Manuela Carvalheiro1
Introduction: Retrospective study, 200307, of 619 GDM women.
Patients and methods: Two groups according to pre-pregnancy BMI: Go ≥30, Gno <30 kg/m2. Influence of BMI in: family history of DM, previous GDM or macrossomia, gestational age at time of GDM diagnosis, weight gain, blood pressure, A1c, need and doses of Insulin, time and type of delivery, new- born weight, complications and re-evaluation post partum.
Results: Mean age 33.03 years old, mean BMI: 26.39, Go: 79.9%=BMI: 34.19 and Gno: 20.1%= BMI: 24.43. Family history Go: 65.2%, Gno: 58.5% P=0.4. Previous GDM Go: 14.1%, Gno: 10.2% P 0.26 Previous macrossomia Go: 10.5%, Gno: 7.3% P=0.3. GA. Ws at GDM diagnosis Go: 26.72 and Gno: 28.75 P=0.002. Weight gain was adequate in 70.7% Gno: 39.6% of Go; excessive in 29.3% Gno: 60.4% Go: P<0.05, OR=3.684. Normal BP in 85.5% Go: 96.0% Gno; cronic hypertension in 6.7% Go: 1.4% in Gno; hypertension induced by pregnancy 3.8% Go and 2.6% Gno. A1c: 5.36% Go: 5.15% Gno: P<0.05. Insulin 42% Go: 28.1% Gno: P<0.05; OR=1.851, beginning of insulin (ws) Go: 29.11, Gno: 30.27 (P=0.28) and total dose Go: 22.4 U/d and Gno: 16.85 U/d P=0.025. Caesarean section Go: 37%, Gno: 33.3%. Macrossomic 9.9% Go: 6.7% in Gno: P=0.24. Fetal morbility 8.5% Go: 5.9% Gno: P=0.33. Re-evaluation: Normal 82% Go: 91.5% in Gno: IFT 11.5% Go: 2.4% Gno, IGT 6.6% Go: 4.9% Gno and DM in 1.2% Gno.
Conclusions: In GDM obesity was found to be an increased risk factor for maternal and fetal morbility. Earlier GDM diagnose, excessive weight gain, hypertension, earlier insulin need and higher doses, earlier delivery, caesarien delivery, high baby weight and macrosomic babies and fetal morbility. Obesity has a positive correlation with the development of carbohydrates intolerance and is a risk factor for maternal and fetal outcomes.