Predicting pregnancy complications: overweight, predisposition to diabetes add up

  • BMC Pregnancy Childbirth

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Women who are both overweight and have a predisposition to diabetes mellitus (DM) have the highest risk for an adverse pregnancy complication.

Why this matters

  • The combination of overweight and predisposition to DM may be synergistic.

Key results

  • The highest frequency of cesarean delivery (CD) was 24.0% and was found among those with overweight/predisposition to diabetes.
  • The highest frequency of large for gestational age (LGA) was 23.3%, also in this group
  • Compared with controls, overweight alone was linked to increased risk for:
    • LGA: 7.1% vs 2.9% without; and
    • CD: 14.9% vs 10.1% without (P<.001 for both>
  • Compared with controls, predisposition to diabetes alone was linked to increased risk for LGA: 11.6% vs 2.9% without (P<.001>

Study design

  • Retrospective population-based cohort study (n=29,488).
  • Cohort from a Swedish population register.
  • Women ages 25-65 years who had pregnancy data were included (n=13,037).
  • Predisposition to diabetes was defined as onset of diabetes after pregnancy.
  • Cohort stratified into 4 groups: overweight; overweight plus predisposition to diabetes; normal weight and predisposition to diabetes; and controls.
  • Funding: Research Funds in Region Skane; Medical Faculty, Lund; University Hospital in Lund; Swedish Cancer Society.

Limitations

  • No identification of predisposition to diabetes during pregnancy.