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Gestational diabetes and gestational weight loss

Gestational diabetes and gestational weight loss

Keep an eye on portion sizes dianetes eat small, frequent meals and snacks every hours. Statistical analyses Statistical analyses were performed using the SPSS software package version Supplementary Information.

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Gestational diabetes and gestational weight loss -

These data conformed with previous reports that women in the highest BMI category gained less weight than those in the lowest category among nondiabetic or mixed populations of pregnant women 26 , Though these results cannot be wholly explained by the current analysis, they may highlight a bias in the emphasis on management of diabetes during pregnancy among care providers, where by the message relating to weight management is reinforced more vigorously in obese rather than overweight women.

The odds of cesarean section were increased in both overweight OR 1. Researchers agree that there is a substantial relationship between BMI and cesarean delivery, but the relationship between maternal weight gain and cesarean delivery has recently become a controversial subject.

For example, Ines Gante et al. Consistent with previous studies 28 , we found that women in the excessive GWG group had a higher likelihood of emergency cesarean delivery than those in the adequate GWG group.

Our study showed that the odds of GHT were much higher in women who were overweight or obese before pregnancy ORs 4. The observations concur with data from several previous investigations on those pregnant women with or without GDM.

Gaillard et al. Tanaka T 31 reported that GHT was associated with an increased pre-pregnancy BMI and high GWG. Although we initially noted a increased incidence of GHT in women with excessive GWG 3. After adjustments were made for possible confounding factors, the odds of LGA and macrosomia were calculated to be higher in women who were overweight or obese before pregnancy.

In addition, the odds of LGA and macrosomia were reduced in underweight women ORs 0. We also observed that excessive GWG increased the incidence of infant macrosomia, while inadequate GWG decreased the incidence of LGA. Consistent with these findings, Mary HB et al.

Our stratification of underweight, normal weight, overweight and obese groups of women also allowed us to detect decreased risk of LGA and macrosomia for underweight compared with normal-weight women. Futhermore, we did not find increased odds of SGA in underweight and inadequate GWG group.

Based on these findings, we speculate that GDM women with lower pre-pregnancy BMI or lower GWG are somewhat protected against LGA. Perhaps a weight gain less than IOM recommended weight gain would be adequate for women with GDM.

In our study, GWG was inversely correlated with the risk of having an SGA baby and directly correlated with the risk of LGA. A weight gain of 8. The IOM recommends a gain of Based on these data, we would recommend that lower thresholds for weight gain may improve outcomes in women with GDM.

Further research is required to determine what range of gestational weight gain minimized the risk of having infants too small or large for gestational age among gestational diabetic women with different pre-pregnancy BMI. Going forward, the specific actions recommended by the IOM in the new guidelines should also include recommendations for the populations of diabetic women.

There are several limitations to the current study. This was an observational, retrospective, single-center study, hence selection and information bias cannot be ruled out, and the enrolled cohort may not be representative of the general population in China or beyond.

We only had access to mode of delivery, but had no access to the type of caesarean. Therefore the influence of maternal pre-pregnancy weight and gestational weight on different types of caesarean may be different. Thus, the results may not be too reliable. Women with GDM received intervention during the third trimester dietary control of energy intake plus insulin therapy if required , which may have influenced the associations between GWG and perinatal outcomes.

Despite these limitations, our study has several strengths. Acknowledging the limitations associated with observational study design and associated influence of measured and unmeasured covariates, we have used adjusted multivariate regression analysis to provide convincing and strong associations of pre-pregnancy BMI and GWG with perinatal outcomes in women with gestational diabetes mellitus.

We have also used strong, validated classification systems for the definition of GWG and BMI. Moreover, cubic spline logistic regression analysis was performed to examine potential nonlinear associations between small or large size for gestational age and gestational weight gain in each maternal BMI category.

Knowledge of this information may help us to better understand whether IOM recommendations are applicable to Chinese women with GDM. In summary, our data suggest that high pre-pregnancy BMI and excessive GWG are associated with higher incidences of LGA, as well as other adverse outcomes in Chinese women with GDM.

Narrower guidelines for GWG might be safer and beneficial in a gestational diabetic population. Further research should set out to determine the optimal range of GWG in order to minimize the risk of adverse perinatal outcomes.

This investigation conforms to the principles outlined in the Declaration of Helsinki. This study was approved by the Ethics Committee of The Hospital of Maternity and Child Health Care, Nanjing, China, No.

All patients provided written informed consent prior to participation in the study protocol. The present study is a retrospective analysis of data collected prospectively from women who delivered single live babies at the Nanjing Maternity and Child Health Care Hospital affiliated to Nanjing Medical University between December and December During the study period, the total number of live births was 15, Of these live births, 9.

All women confirmed with GDM were invited to participate in the trial unless they had one or more of the following exclusion criteria: an incomplete dataset available; multiple pregnancy; a history of hypertension, diabetes, heart disease, hepatitis, chronic renal disease or other systemic disease.

Finally, a total of women were included in this study. Oral glucose tolerance tests OGTT were measured by a 1 step approach between 24th and 28th weeks of gestation. The maternal age, glycated hemoglobin at diagnosis, gestational week at delivery, parity, maternal body mass index BMI , maternal weight gain, birth weight and the glucose levels of GDM patients were recorded.

Body mass index BMI was calculated by dividing pre-pregnancy weight in kilograms by the square of height in meters. Weight gain of mothers during pregnancy was calculated as the difference between pre-pregnancy and delivery weight. Adequacy of GWG was defined according to the Chinese maternal pre-pregnancy BMI status and the IOM GWG recommendations: We used the translation of US IOM GWG recommendations because no official recommendation exists in China.

We considered the risks of caesarean section, postpartum hemorrhage, preterm birth preterm delivery , preterm premature rupture of membranes, pregnancy-induced hypertension, macrosomia, small for gestational age SGA infant, large for gestational age LGA infant as pregnancy complications and pregnancy outcomes.

Preterm premature rupture of membranes PPROM was defined as a spontaneous rupture of membranes before the onset of labor and before 37 weeks of gestation. All women with GDM received a recommendation for their diet during pregnancy.

For those women who had poor glycemic control despite dietary and lifestyle intervention, insulin therapy was given. The targets for insulin treatment are fasting glucose level within 3.

Statistical analyses were performed using the SPSS software package version Statistical comparisons of categorical data were made using the chi-square χ 2 test. All continuous data with homogeneity of variance were compared by one way ANOVA with LSD, or by nonparametric K-W test followed by pairwise comparisons.

The P value was adjusted by Bonferroni correction to counter the multiple comparisons between different groups. All ORs were adjusted for maternal age, maternal height and pre-pregnancy BMI or GWG as appropriate. Additional adjustments were made, as follows: gestational weeks and birth weight for cesarean section and PPH; and gestational weeks for GHT, SGA and LGA.

Restricted cubic spline logistic regression analysis 33 , 34 was performed to fit nonlinear curves smoothly using Stata Version 12 Stata Corp LP, College Station, TX, USA. This was done to examine potential nonlinear associations between small or large size for gestational age and gestational weight gain in each maternal BMI category.

Maternal age, parity and gestational weeks were adjusted in the multivariate model. Optimal weight gains were determined from the intersection on the regression graph of maternal weight gain and the probability of delivering an infant too small or too large for gestational age.

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Excessive weight gain during Anr is not associated Gestational diabetes and gestational weight loss an increased risk for developing gestational aand, according to loxs published Relapse prevention techniques the Journal of Gestationa, Investigation. Researchers Improve insulin sensitivity for prediabetes prevention a retrospective cross-sectional study of women who underwent gestational diabetes screening and delivered after 28 weeks anc gestation at Taipei Gestational diabetes and gestational weight loss Gung Memorial Hospital gestaational to Pregnant women were screened for gestational diabetes between 24 and 28 weeks of gestation with a 2-hour oral glucose tolerance test with the exception of high-risk women, who underwent screening at the first prenatal visit. Prepregnancy height and weight were used to calculate pregestational BMI. First trimester gestational weight gain was the difference between weight before pregnancy to 12 to 14 weeks of gestation. Second trimester weight gain was the difference in weight from 12 to 14 weeks and 26 to 28 weeks of pregnancy. Gestational weight gain before diabetes screening was calculated as the difference between prepregnancy weight and weight at screening. BMC Pregnancy and Gestafional volume 21Article number: Cite Gestational diabetes and gestational weight loss article. Metrics details. Gestatiinal diabetes mellitus Citrus fruit salads and excessive body weight gestatlonal two key risk factors for adverse perinatal outcomes. However, it EGstational not clear Olive oil for eye health restricted gestational weight gain GWG is favorable to reduce the risk gestatiobal adverse Blood pressure management and neonatal outcomes in women with GDM. Therefore, this study aimed to assess the association of GWG after an oral glucose tolerance test with maternal and neonatal outcomes. This prospective cohort study assessed the association of GWG after an oral glucose tolerance test OGTT with pregnancy and neonatal outcomes in women with GDM, adjusted for age, pre-pregnancy body mass index, height, gravidity, parity, adverse history of pregnancy, GWG before OGTT, blood glucose level at OGTT and late pregnancy. The outcomes included the prevalence of pregnancy-induced hypertension PIH and preeclampsia, large for gestational age LGAsmall for gestational age, macrosomia, low birth weight, preterm birth, and birth by cesarean section.

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