Karen Wong , Stephanie Gill , Phil Murphy , Joan Crane
{"title":"The relative importance of gestational weight gain and pre-gestational diabetes on perinatal outcomes: A retrospective cohort study","authors":"Karen Wong , Stephanie Gill , Phil Murphy , Joan Crane","doi":"10.1016/j.deman.2022.100095","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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, <em>p</em> = 0.12), however more women with pre-gestational diabetes had excessive GWG (85.1% vs. 78.5%, <em>p</em> = 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).</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000452/pdfft?md5=7dec95b2b88ab6c4751a552549a55b97&pid=1-s2.0-S2666970622000452-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666970622000452","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
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.
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.