Introduction: A retrospective study of the year 2003, of 1314 women with GDM, was performed.
Patients and methods: Two groups according to pre-pregnancy BMI: Go - BMI≧30 Kg/m2; Gno BMI<30 Kg/m2. Mean age 32.9±5 years, A1c<6% in both groups. Influence of BMI in different variables was analysed: family history of DM, weight gain during pregnancy; blood pressure, need of insulin, gestation age at the beginning of insulin, time and type of delivery, new-born weight and re-evaluation post-partum.
Results: Mean BMI was 26.7±5.1, 76.3%=BMI<30 and 23.8%=BMI≧30. Family history of DM - BMI 26.93 Kg/m2, without family history −26.19 Kg/m2; P=0.01. Weight gain was adequate in 41.4%, reduced in 29.9% and excessive in 28.7%. Normal arterial blood pressure −86.5%, hypertension worsened by pregnancy −6.9% and pregnancy induced hypertension −6.6%, BMI in these three groups 26.1, 30.51 and 29.33, respectively (P<0.05). There was statistical significant difference (P<0.05) between the two groups in these parameters: Insulin therapy 75.2% in Go vs 52.5% in Gno and its need earlier in Go −28.83 wks vs Gno −30.97 wks; time of delivery 38.1 wks in Go vs 38.4−wks in Gno; caesarean section 49.8% in Go vs 35% in Gno; new- born weight 3324.8 g in Go vs 3167.9 g in Gno; macrosomic babies 8.3% in Go vs 4.4% in Gno. In the re-evaluation post-partum higher BMI was related with severe degrees of carbohydrate intolerance (P<0.05). We didnt find any difference in the re-evaluation between the women with adequate and excessive weight gain.
Conclusions: Obesity in GDM is a risk factor for maternal and fetal outcomes, with the risk of early development in the mother of glucose intolerance.