The relative importance of gestational weight gain and pre-gestational diabetes on perinatal outcomes: A retrospective cohort study

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Karen Wong , Stephanie Gill , Phil Murphy , Joan Crane
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引用次数: 0

Abstract

Aims

The objective of this study is to determine the risks of macrosomia, LGA, and Caesarean section associated with a diagnosis of pre-gestational diabetes or gestational weight gain.

Methods

This is a retrospective cohort study utilizing data from the Perinatal Surveillance Database of Newfoundland & Labrador from 2001 – 2020. Multivariate logistic regression analyses were used to determine odds ratios (OR) associated with GWG and pre-gestational diabetes for the outcomes macrosomia, LGA, and CS, while controlling for other known risk factors.

Results

There were 234 pregnancies complicated by pre-gestational diabetes and 22,048 without diabetes included. There was no significant difference in absolute GWG between groups (15.2 kg vs. 15.5 kg, p = 0.12), however more women with pre-gestational diabetes had excessive GWG (85.1% vs. 78.5%, p = 0.04). Pre-gestational diabetes was a significant predictor of LGA (OR 5.21, 95% CI 3.96 – 6.87), macrosomia (OR 2.63 95% CI 1.98 – 3.48), and Caesarean section (OR 3.44, 95% CI 2.60 – 4.56). The OR associated with excessive GWG were lower for these same outcomes (LGA OR 2.73, 95% CI 2.40 – 3.11; macrosomia 2.38, 95% CI 2.12 – 2.69; Caesarean section OR 1.29, 95% CI 1.19 – 1.39).

Conclusions

We have identified that pre-gestational diabetes is the most significant risk factor for poor outcomes such as LGA, macrosomia, and Caesarean section, although excessive GWG also plays a role.

妊娠期体重增加和妊娠前糖尿病对围产期结局的相对重要性:一项回顾性队列研究
目的本研究的目的是确定巨大儿、LGA和剖腹产的风险与孕前糖尿病或妊娠期体重增加的诊断相关。方法回顾性队列研究利用纽芬兰围产期监测数据库的数据;2001 - 2020年的拉布拉多。在控制其他已知危险因素的同时,采用多因素logistic回归分析确定与GWG和孕前糖尿病相关的巨大儿、LGA和CS的比值比(OR)。结果234例妊娠合并妊娠前糖尿病,22048例未合并妊娠糖尿病。绝对GWG在两组间无显著差异(15.2 kg对15.5 kg, p = 0.12),但更多的妊娠前糖尿病妇女GWG过高(85.1%对78.5%,p = 0.04)。妊娠前糖尿病是LGA (OR 5.21, 95% CI 3.96 - 6.87)、巨大儿(OR 2.63, 95% CI 1.98 - 3.48)和剖宫产(OR 3.44, 95% CI 2.60 - 4.56)的重要预测因子。在这些相同的结果中,与过量GWG相关的OR较低(LGA OR 2.73, 95% CI 2.40 - 3.11;巨大儿2.38,95% CI 2.12 - 2.69;剖宫产(OR 1.29, 95% CI 1.19 - 1.39)。结论妊娠前期糖尿病是LGA、巨大儿和剖宫产等不良结局的最重要危险因素,尽管GWG过高也起一定作用。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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