PREGNANCY COMPLICATIONS AND OUTCOMES IN OBESE WOMEN WITH GESTATIONAL DIABETES
Abstract
Aim: To evaluate the impact of pre-pregnancy obesity in women with gestational diabetes mellitus (GDM) pregnancy and delivery complications and influence on neonatal weight and condition after birth. Methods: A retrospective study was performed using the data from the Department of Obstetrics and Gynecology of the Lithuanian University of Health Sciences (LUHS) Birth Registry from 2019. We included 581 women who had GDM and singleton pregnancy, women were divided into groups according to their pre-pregnancy weight: 202 were obese and 379 had normal weight. The data was analyzed with “SPSS/w26.0” and MS Excel 2016 software. The results: Fasting glycemia is higher in obese women with GDM than in women of normal weight (5.67 (5-7; 5.78) and 5.49 (5-8; 5.56), p <0.001), fasting glycemia is higher in obese women with GDM A2 than in normal weight women (5.69 (5-7; 5.86) and 5.48 (5-7; 5.58), p = 0.006). GTM 0 min glycemia was higher in obese than in non-obese women with gestational diabetes (5.45 (3-8; 5.52) and 5.20 (3-8; 5.19), p <0.001).Women with pre-pregnancy obesity more often had primary hypertension (18.8% and 2.9%, p<0.001), pregnancy-induced hypertensive conditions (47.5% and 19%, p<0,001), gestational cholestasis (6,4% and 1,6%, p=0,002), polyhydramnios (19,4% and 5.5%, p<0.001), induced labor (75.4% and 24.6%., p<0.001), Caesarean section (24.8% and 16.4%, p=0.015) (emergency Caesarean section more often than planned (66% and 41.9%, p=0.011)) compared to normal body weight women with GDM. Labor dystocia (9.4% and 3.4%, p=0.003) and unstable fetal condition (4% and 1.1%, p=0,019) occurred more often during delivery between obese women. Neonates of these women more often had macrosomia (22.8% and 10%, p<0.001) and had lower Apgar scores after 1 min (9 (2-10; 8.9) and 9 (3-10; 9.06), p=0.024) and after 5 min 10 (6-10; 9.52) and 10 (6-10; 9.66), p=0.024) compared to normal body weight women. Conclusions: Obese women with GDM have more pregnancy and labor complications than normal weight women with GDM.
