Effect of obesity on neonatal hypoglycaemia in mothers with gestational diabetes: A comparative study
Katherine Collins1, Raoul Oehmen2, Shailender Mehta2,3,4
1Fiona Stanley Hospital, Perth, Western Australia, Australia.
Insights
Maternal pre-pregnancy obesity and excessive gestational weight gain significantly increase the risk of neonatal hypoglycemia in infants born to mothers with gestational diabetes mellitus (GDM). This highlights the importance of weight management during pregnancy for better infant outcomes.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Endocrinology
Background:
- Increasing rates of pre-gestational obesity and gestational diabetes mellitus (GDM) in Australia present a growing public health concern.
- Both obesity and GDM are known risk factors for neonatal hypoglycemia, but their combined impact requires further elucidation.
Purpose of the Study:
- To investigate the influence of maternal pre-pregnancy obesity on the incidence and severity of neonatal hypoglycemia in infants born to mothers with GDM.
- To assess the additive risks of obesity and GDM on neonatal hypoglycemia.
Main Methods:
- A retrospective cohort study of 471 singleton pregnancies diagnosed with GDM.
- Mothers were categorized into obese (BMI ≥ 30 kg/m²) and non-obese (BMI < 30 kg/m²) groups based on pre-pregnancy BMI.
- Perinatal outcomes, including neonatal hypoglycemia episodes, were analyzed from medical records.
Main Results:
- Maternal obesity was observed in 25% of the GDM cohort, with 36% exceeding recommended pregnancy weight gain.
- Infants of obese mothers with GDM experienced a higher frequency of neonatal hypoglycemia (44%) compared to non-obese mothers with GDM (34%).
- Obesity was associated with an increased likelihood of multiple hypoglycemic episodes, and excess weight gain correlated with the need for intravenous dextrose.
Conclusions:
- Pre-pregnancy obesity and excessive gestational weight gain are significant risk factors that increase the likelihood of neonatal hypoglycemia in infants born to mothers with GDM.
- These findings underscore the importance of preconception counseling and management of weight in GDM pregnancies.
- Larger cohort studies are recommended to validate these findings and explore underlying mechanisms.
Background:
Rates of pre-gestational obesity and gestational diabetes mellitus (GDM) are increasing in Australia. While both are established risk factors for neonatal hypoglycaemia, the additive effect of both risks on neonatal hypoglycaemia is not well understood.
Aims:
To determine the influence of obesity on neonatal hypoglycaemia among infants born to GDM mothers. The authors hypothesise the presence of a greater frequency and severity of neonatal hypoglycaemia in infants born to obese GDM women.
Materials And Methods:
A cohort of 471 singleton GDM pregnancies was retrospectively studied. Women were divided into obese (body mass index (BMI) ≥ 30 kg/m2 ) and not-obese (BMI < 30 kg/m2 ) groups according to self-reported pre-pregnancy weight. Perinatal outcomes and details of hypoglycaemic episodes were obtained by reviewing medical records.
Results:
Twenty-five percent (104/410) of the GDM mothers were obese, while 36% (146/410) exceeded pregnancy weight gain recommendations. GDM and obesity resulted in a greater frequency of neonatal hypoglycaemia as compared to women with GDM alone (obese 44%, not obese 34%, P = 0.046). Obesity increased the likelihood of having multiple hypoglycaemic episodes (P = 0.022). Excess weight gain increased the likelihood of the neonate requiring intravenous dextrose (P = 0.0012). No differences were found in the likelihood of nursery admissions or lowest plasma glucose levels.
Conclusions:
Pre-pregnancy obesity and weight gain during pregnancy above the recommended limits increased the likelihood of neonatal hypoglycaemia among infants of GDM mothers. Further studies with larger cohorts are warranted to confirm our findings.
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