Maternal BMI, glucose tolerance, and adverse pregnancy outcomes

Alison M Stuebe, Mark B Landon, Yinglei Lai, Catherine Y Spong, Marshall W Carpenter, Susan M Ramin, Brian Casey, Ronald J Wapner, Michael W Varner, Dwight J Rouse, Anthony Sciscione, Patrick Catalano, Margaret Harper, George Saade, Yoram Sorokin, Alan M Peaceman, Jorge E Tolosa, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD, J Thorp, K Dorman, S Brody, S Timlin, J Bernhardt, K Leveno, L Moseley, J Gold, D Bradford, L Fay, M Garcia, F Capellan, M Miodovnik, F Malone, S Bousleiman, H Husami, V Carmona, N Fredericks, E Gantioqui, B Greenspan, M Williams, K Anderson, P Ashby, S McAllister, S Quinn, A Guzman, F Castinella, J Steiner, J Parker, J Sheppard, J Tisdale, A Northen, W Andrews, D Catlow, D Allard, M Seebeck, J Tillinghast, J Iams, F Johnson, C Latimer, E Weinandy, B Maselli, M Hoffman, E Guzman, M Talucci, T Grossman, C Perez, L Zeghibe, P Tabangin, B Mercer, B Stetzer, C Milluzzi, W Dalton, S Pichette, M Swain, P Meis, J White, L Gilstrap, K Cannon, J Martinez, D Dusek, J Moss, J Brandon, A Jackson, G Hankins, D Sharp, S Caritis, M Bickus, H Birkland, M Cotroneo, N Cuddy, G Norman, P Lockhart, S Blackwell, L Quast, P Simon, G Mallett, L Davis, E Lairson, C Cromett, C Naze, M Blaser, E Thom, L Mele, J Zachary, B Getachew, C Cobb, L Leuchtenburg, S Gilbert, S Tolivaisa, K Howell, G D Anderson, Alison M Stuebe, Mark B Landon, Yinglei Lai, Catherine Y Spong, Marshall W Carpenter, Susan M Ramin, Brian Casey, Ronald J Wapner, Michael W Varner, Dwight J Rouse, Anthony Sciscione, Patrick Catalano, Margaret Harper, George Saade, Yoram Sorokin, Alan M Peaceman, Jorge E Tolosa, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD, J Thorp, K Dorman, S Brody, S Timlin, J Bernhardt, K Leveno, L Moseley, J Gold, D Bradford, L Fay, M Garcia, F Capellan, M Miodovnik, F Malone, S Bousleiman, H Husami, V Carmona, N Fredericks, E Gantioqui, B Greenspan, M Williams, K Anderson, P Ashby, S McAllister, S Quinn, A Guzman, F Castinella, J Steiner, J Parker, J Sheppard, J Tisdale, A Northen, W Andrews, D Catlow, D Allard, M Seebeck, J Tillinghast, J Iams, F Johnson, C Latimer, E Weinandy, B Maselli, M Hoffman, E Guzman, M Talucci, T Grossman, C Perez, L Zeghibe, P Tabangin, B Mercer, B Stetzer, C Milluzzi, W Dalton, S Pichette, M Swain, P Meis, J White, L Gilstrap, K Cannon, J Martinez, D Dusek, J Moss, J Brandon, A Jackson, G Hankins, D Sharp, S Caritis, M Bickus, H Birkland, M Cotroneo, N Cuddy, G Norman, P Lockhart, S Blackwell, L Quast, P Simon, G Mallett, L Davis, E Lairson, C Cromett, C Naze, M Blaser, E Thom, L Mele, J Zachary, B Getachew, C Cobb, L Leuchtenburg, S Gilbert, S Tolivaisa, K Howell, G D Anderson

Abstract

Objective: The purpose of this study was to estimate the association of pregravid body mass index (BMI), independent of 3-hour oral glucose tolerance test (OGTT) results, with pregnancy outcome.

Study design: In this secondary analysis of a cohort of women with untreated mild gestational glucose intolerance, which was defined as a 50-g glucose loading test between 135 and 199 mg/dL and fasting glucose level of <95 mg/dL, we modeled the association between pregravid BMI, OGTT results, and both pregnancy complications and neonatal adiposity.

Results: Among 1250 participants, both pregravid BMI and glucose at hour 3 of the OGTT were associated with increased risk of gestational hypertension. Maternal pregravid BMI also was associated positively with large-for-gestational-age infants; both maternal BMI and fasting glucose were associated with birthweight z-score and neonatal fat mass.

Conclusion: Among women with untreated mild gestational glucose intolerance, pregravid BMI is associated with increased gestational hypertension, birthweight, and neonatal fat mass, independent of OGTT values.

Conflict of interest statement

Disclosure: None of the authors have a conflict of interest.

Copyright © 2012 Mosby, Inc. All rights reserved.

Figures

Figure 1
Figure 1
Predicted probability* of primary outcome, gestational hypertension, preeclampsia, SGA and LGA, by prepregnancy maternal BMI. Predicted probabilities of pregnancy outcome presented for a hypothetical multiparous white women with mean values for age (27.9) and OGTT values (fasting: 85.3, 1h: 166.5, 2h: 144.3, 3h: 117.1). Models include parity, maternal age, race/ethnicity, maternal pregravid BMI and all four OGTT values.
Figure 2
Figure 2
Predicted birth weight z-score and fat mass by prepregnancy maternal BMI. Predicted birth weight z-score and neonatal fat mass presented for a hypothetical multiparous white women with mean values for age (27.9) and OGTT values (fasting: 85.3, 1h: 166.5, 2h: 144.3, 3h: 117.1). Models include parity, maternal age, race/ethnicity, maternal pregravid BMI and all four OGTT values.

Source: PubMed

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