Poster Australasian Diabetes in Pregnancy Annual Scientific Meeting 2013

IMPACT OF OBESITY ON PREGNANCY OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES MELLITUS (#106)

Jeff R Flack 1 2 , Glynis P Ross 1 , Robyn A Barnes 1
  1. Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
  2. University of NSW, Sydney, NSW, Australia

Background: Obesity is increasing in the community and is associated with adverse pregnancy outcomes.
Aims: To assess the proportions of obese versus normal and overweight women, and compare their pregnancy outcomes from a large GDM cohort in South-Western Sydney.
Methods: Retrospective analysis of prospectively collected data from our GDM database, (1993-2012), on women diagnosed and managed by ADIPS criteria(1). Selected women had delivery outcome data and had attended a post-partum oGTT. Post-partum glycaemic status was classified according to oGTT results, (not HbA1c), with IFG being FBGL≥6.1mmol/L. Data were compared by t-test or Chi-squared test. Fisher-Freeman-Halton exact test was used to detect differences in ethnicity. Statistical significance was p<0.05.
0>Results: There were 1851 women with available data: 77.8% BMI (kg/m2) 18.5-29.9 [Gp1], and 22.2% with BMI ≥30 [Gp2]. There were differences in ethnicity with significantly lower numbers of South-East Asian and South Asian women in Gp2. Data in the Table show that obese women were slightly older, were diagnosed slightly earlier and had higher gravida and parity. There was statistically significantly higher insulin use and mean maximum dose (40.8 versus 28.9 units). Overall weight gain was less in the obese women and there was no increase in early delivery, although there were more caesarean births. There were no significant differences in baby outcomes including shoulder dystocia (3 in the Gp2 versus 7 in Gp1). SGA rates were similar but there were more LGA babies and more post-partum dysglycaemia in the obese GDM women.

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Conclusions: In this cohort, obese women with GDM were more likely to require insulin therapy, to undergo caesarean delivery, had more LGA babies and post-partum dysglycaemia than those who were normal weight and overweight combined. These data highlight the need for particular attention to weight management including prior to pregnancy.

Acknowledgment: All of the Diabetes Educators who have collected data and maintained the database.

  1. Hoffman L, Nolan C, Wilson JD, Oats JJN, Simmons D. Gestational diabetes mellitus – management guidelines. The Australasian Diabetes in Pregnancy Society. Med J Aust 1998; 169:93–97.
  2. Acknowledgment: All of the Diabetes Educators who have collected data and maintained the database.