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Perinatal Outcomes Associated with Early Diabetes Testing in Pregnancies Complicated by Obesity

John F Mission1,2, Janet Catov3, Diane Comer4

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.

American Journal of Perinatology
|March 22, 2019
PubMed

Insights

Early diabetes testing in pregnant women with obesity increases diabetes diagnosis rates. However, it may also raise risks for small for gestational age birth weight and neonatal complications, especially with inadequate weight gain.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatal Medicine

Background:

  • Obesity in pregnancy is a significant risk factor for adverse perinatal outcomes.
  • Timely screening for gestational diabetes is crucial for managing maternal and fetal health.

Purpose of the Study:

  • To investigate the association between early diabetes testing and perinatal outcomes in pregnant women with obesity (BMI ≥30 kg/m²).

Main Methods:

  • Retrospective cohort study of singleton pregnancies (2012-2014).
  • Examined early diabetes testing (HbA1c, glucose challenge, or oral glucose tolerance tests before 24 weeks).
  • Utilized propensity score modeling and logistic regression to analyze associations.

Main Results:

  • Early testing was performed in 29.3% of women with obesity.
  • Early testing was linked to higher diabetes diagnosis rates (OR: 1.62) and a trend towards increased small for gestational age (SGA) birth weight (OR: 1.38) and neonatal composite morbidity (OR: 1.25).
  • Women with inadequate weight gain undergoing early testing had higher rates of SGA infants (19.8% vs. 11.6%).

Conclusions:

  • Early diabetes testing in obese pregnant women identifies more cases of diabetes but may be associated with increased risks for SGA birth weight and neonatal morbidity, particularly when weight gain is inadequate.
  • Further research, including randomized clinical trials, is essential to confirm these findings and guide clinical practice.
Abstract

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