ResearchObstetricsMaternal BMI, glucose tolerance, and adverse pregnancy outcomes
Section snippets
Materials and Methods
We performed a secondary analysis of women with untreated mild gestational glucose intolerance. Participants were women who were assigned randomly to no treatment in the previously reported Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network multicenter randomized trial of treatment for mild GDM and women in the associated observational cohort, which comprised women with a 50-g glucose screen of ≥135 mg/dL who did not meet
Results
Of the 1250 women who were eligible for inclusion in our analysis, most were Hispanic (54.2%). The mean maternal age was 27.9 years, and 34% of the women were nulliparous (Table 1).
Maternal pregravid BMI correlated with fasting 3-hour OGTT results (r = 0.16; P < .001). BMI was also associated with the 1-hour value on the 3-hour OGTT and inversely associated with 3-hour value. We found correlations among all 4 3-hour OGTT parameters (all P ≤ .005), with the strongest correlations among post-load
Comment
In a secondary analysis of a cohort of women with 50-g glucose loading test screen between 135 and 199 mg/dL and a normal fasting glucose level, we found that elevated maternal pregravid BMI was associated with hypertensive complications, infant birthweight z-score, and fat mass, independent of 3-hour OGTT results. These findings suggest that elevated maternal pregravid BMI is an independent risk factor for adverse birth outcomes and neonatal adiposity, with the caveat that our cohort was
Acknowledgments
We thank the following MFMU Network members who participated in protocol development and coordination between clinical research centers (Francee Johnson, RN, MSN, and Jo-Ann Tillinghast, RN, MSN), protocol/data management and statistical analysis (Elizabeth Thom, PhD), and protocol development and oversight (John M. Thorp Jr, MD).
References (34)
- et al.
Anthropometric estimation of neonatal body composition
Am J Obstet Gynecol
(1995) - et al.
Obesity or diabetes: what is worse for the mother and for the baby?
Diabetes Metab
(2003) - et al.
The influence of obesity and diabetes on the prevalence of macrosomia
Am J Obstet Gynecol
(2004) - et al.
Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women
Am J Obstet Gynecol
(2003) - et al.
Prepregnancy BMI influences maternal and fetal outcomes in women with isolated gestational hyperglycaemia: a multicentre study
Diabetes Metab
(2010) - et al.
Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial
Am J Clin Nutr
(2010) - et al.
Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies
BMC Public Health
(2007) - et al.
The prevalence and impact of overweight and obesity in an Australian obstetric population
Med J Aust
(2006) - et al.
Prepregnancy body mass index and adverse pregnancy outcomes
Arch Gynecol Obstet
(2008) - et al.
The effects of maternal body mass index on pregnancy outcome
Eur J Epidemiol
(2009)
Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London
Int J Obes Relat Metab Disord
ACOG practice bulletin no. 30: gestational diabetes
Obstet Gynecol
Maternal metabolism and obesity: modifiable determinants of pregnancy outcome
Hum Reprod Update
Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia
Diabetes Care
A multicenter, randomized trial of treatment for mild gestational diabetes
N Engl J Med
Effect of treatment of gestational diabetes mellitus on pregnancy outcomes
N Engl J Med
1994-1996 US singleton birthweight percentiles for gestational age by race, Hispanic origin, and gender
Matern Child Health J
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Supported by the following grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): nos. HD27915, HD34116, HD40485, HD34208, HD27869, HD40500, HD40560, HD34136, HD40544, HD27860, HD40545, HD53097, HD21410, HD27917, HD40512, HD53118, and HD36801; General Clinical Research Centers grant no. M01-RR00034; and National Center for Research Resources grant nos. UL1-RR024989, M01-RR00080, UL1-RR025764, and C06-RR11234. A.M.S. receives support from the Women's Reproductive Health Research Career Development Center at the University of North Carolina (grant no. 5K12HD050113-04).
This work does not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.
The authors report no conflict of interest.
The other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network are listed in the Appendix.
Cite this article as: Stuebe AM, Landon MB, Lai Y, et al. Maternal BMI, glucose tolerance, and adverse pregnancy outcomes. Am J Obstet Gynecol 2012;207:62.e1-7.