Search

Objectives This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus. Study Design This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis. Results A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17–0.63; p = 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04–3.58; p = 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32–3.90; p = 0.003), neonatal intensive unit admission (aOR, 3.29; 95% CI, 1.10–5.78; p = 0.038), pneumonia (aOR, 2.41; 95% CI, 1.08–5.33; p = 0.031), and neonatal respiratory distress syndrome (aOR, 2.29; 95% CI, 1.10–4.78; p = 0.027); the infants of women with excessive gestational weight gain had a higher risk of large for gestational age (aOR, 3.76; 95% CI, 1.42–9.96; p = 0.008). Conclusion Gestational weight gain controlled within the range recommended by the NAM could reduce the risk of perinatal adverse outcomes. The 2009 NAM gestational weight gain recommendations can be used for Chinese twin-pregnant women with gestational diabetes mellitus. Key Points Inappropriate gestational weight gain can lead to adverse perinatal outcomes in twin pregnancies. Gestational weight gain controlled within recommended range could reduce the risk of poor perinatal outcomes. The National Academy of Medicine recommendations are suitable for Chinese twin-pregnant women with GDM. [ABSTRACT FROM AUTHOR]

Aim: To examine the optimal gestational weight gain (GWG) for Chinese pregnant women with gestational diabetes mellitus (GDM) based on the Chinese‐specific body mass index (BMI) classification. Methods: A retrospective cohort study was conducted using the 2017–2020 data from pregnant women with GDM in a tertiary hospital. A quadratic function model and the total predicted probability of adverse pregnancy outcomes were developed to obtain the optimal GWG. Differences in the incidence of adverse pregnancy outcomes between our optimal GWG recommendations and the Institute of Medicine (IOM) 2009 GWG guidelines were also analyzed. Results: A total of 8103 pregnant women with GDM were analyzed. Based on the Chinese‐specific BMI classification, the optimal GWG range was 11.0–17.5 kg for underweight women, 3.7–9.7 kg for normal‐weight women, −0.6 to 4.8 kg for overweight women, and − 9.8 to 4.2 kg for obese women. Excessive GWG had a higher risk of large for gestational age (LGA) (OR: 2.99, 95% CI: 2.42–3.70), macrosomia (OR: 2.35, 95% CI: 1.77–3.12), pre‐eclampsia (OR: 1.91, 95% CI: 1.37–2.65), gestational hypertension (OR: 1.65, 95% CI: 1.24–2.19), cesarean section (OR: 1.29, 95% CI: 1.15–1.44), postpartum hemorrhage (OR: 1.29, 95% CI: 1.02–1.64); insufficient GWG had a higher risk of small for gestational age (OR: 1.82, 95% CI: 1.20–2.75). Compared to the IOM 2009 GWG guidelines, the prevalence of macrosomia, LGA, and postpartum hemorrhage were significantly lower in pregnant women following the implementation of our recommended GWG range (p < 0.05). Conclusions: Compared to the IOM 2009 GWG recommendations, our optimal GWG recommendations for Chinese pregnant women were more sensitive. [ABSTRACT FROM AUTHOR]

Aim: To explore the effect of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus (GDM). Methods: This retrospective study reviewed the medical records of women with GDM delivered at the Chongqing Maternal and Child Health Hospital in China between July 2017 and December 2020. The live singleton pregnancies with α or β‐thalassemia were identified as the thalassemia group, included α‐thalassemia subgroup and β‐thalassemia subgroup, whereas pregnant women without thalassemia were randomly selected as the non‐thalassemia group according to a control‐to‐case ratio of 10:1 by computerized randomization. Logistic regression analyses were used to explore the potential association between thalassemia and pregnancy outcomes. Results: A total of 223 pregnant women with GDM and thalassemia were analyzed, including women with α‐thalassemia (n = 143) and β‐thalassemia (n = 80). There were no significant differences in the incidence of adverse neonatal outcomes such as preterm birth and low‐birth weight among groups. However, among pregnancy complications, significant differences were detected in the incidence of placenta increta, polyhydramnios, and postpartum anemia between the thalassemia group and the non‐thalassemia group. Logistic regression results indicated that β‐thalassemia increased the risk of polyhydramnios (odds ratio [OR] = 3.95, 95% confidence interval [CI]: 1.14–13.65, p = 0.030) and chorioamnionitis (OR = 3.61, 95%CI: 1.04–12.49, p = 0.043) compared with the non‐thalassemia group. Conclusion: In our study, thalassemia did not increase adverse neonatal outcomes, but β‐thalassemia increased the risk of pregnancy complications, including polyhydramnios and chorioamnionitis. [ABSTRACT FROM AUTHOR]

[Display omitted] • Combined HBV and GDM increases the risk of fetal femur length overgrowth. • Combined HBV and GDM increases the risk of placental abruption and macrosomia. • A combination of HBV and GDM has a greater impact than either one alone. To investigate the impact of pregnancy with combined hepatitis B virus (HBV) infection and Gestational diabetes mellitus (GDM) on fetal growth and adverse perinatal outcomes. All the pregnant women with HBV infection and/or GDM who delivered at Women's Hospital, Zhejiang University between January 2015, and September 2022 were included. A total of 1633 pregnant women were recruited in the final analysis, including 409 women with HBV infection and GDM, 396 with HBV infection only, 430 with GDM only, and 398 without HBV infection and GDM. Linear and logistic regression models were used to study the impact of pregnancy with combined HBV infection and GDM on fetal growth and adverse perinatal outcomes. Pregnancy with combined HBV infection and GDM was associated with increased Z-scores on primary fetal ultrasound parameters and significantly increased the risk of fetal femur length overgrowth (OR: 2.88, 95 % CI: 1.13 ∼ 7.35), placental abruption (OR: 3.64, 95 % CI: 1.18 ∼ 11.22), and macrosomia (OR: 4.19, 95 % CI: 1.66 ∼ 10.56) compared to pregnancy without HBV infection and GDM. Both maternal HBV infection and GDM are independently associated with adverse perinatal outcomes. Their combination further increases the risk of adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Aims: To explore the impact of HBV infection on maternal and infant outcomes of GDM women.Methods: We retrospectively identified 8126 women with GDM in China from July 2017 to June 2020, and divided them into GDM with HBV infection group (n = 483) and GDM with non-HBV infection group (n = 7643). Two sample t-test and Chi-square test were used to compare differences between groups. Logistic regression models were used to explore the association between HBV infection and maternal and infant outcomes.Results: Placental abruption (PA), (2.3% vs. 1.0%, P = 0.008), placenta previa (4.3% vs. 2.8% p = 0.044), intrahepatic cholestasis of pregnancy (ICP), (6.4% vs. 3.0%, P < 0.001), cesarean section (52.0% vs. 46.0%, P = 0.011), fetal chromosomal abnormalities (1.2% vs. 0.4%, P = 0.021), and neonatal hyperglycemia (1.9% vs. 3.6%, P = 0.047) were more likely to occur in GDM with HBV infection group. After adjusting for the covariates, HBV infection was found to be associated with ICP (aOR, 2.35; 95% CI: [1.58-3.50]), PA (aOR, 2.34; 95% CI: 1.22-4.47), and fetal chromosomal abnormalities (aOR, 2.88; 95% CI: 1.18-7.03).Conclusions: HBV infection was associated with part of maternal and infant outcomes in the GDM population. [ABSTRACT FROM AUTHOR]