J Korean Med Sci.  2023 Aug;38(33):e268. 10.3346/jkms.2023.38.e268.

Obesity Is Associated With Higher Risk of Adverse Maternal and Neonatal Outcomes Than Supervised Gestational Diabetes

• Seo N
• Lee YM
• Kim Yj
• Sung Jh
• Hur KY
• Choi SJ
• Roh CR
• Oh Sy

• KMID: 2545214
• DOI: http://doi.org/10.3346/jkms.2023.38.e268

Abstract

Background
Unlike gestational diabetic mellitus (GDM), which is strictly managed by most patients and physicians, obesity does not have proper management guidelines, and the importance of its management during pregnancy is often ignored. The aim of this study was to compare maternal and neonatal outcomes according to obesity and GDM, alone or in combination.
Methods
This was a retrospective cohort study of 3,078 consecutive pregnant women who experienced prenatal care and delivery of a live singleton neonate between January 2016 and December 2020 at our institution. Study participants were categorized into 4 mutually exclusive groups, as follows: group 1, no GDM without obesity; group 2, GDM without obesity; group 3, no GDM with obesity; and group 4, GDM with obesity.
Results
Compared to group 2, group 3 had higher rates of pre-eclampsia, cesarean section including emergent cesarean section rate. Also, neonates in group 3 were heavier and had lower glucose levels compared to those in group 2. Of note, there was no significant difference in maternal or neonatal outcomes except the rate of large-for-gestational-age (LGA) between group 1 and group 2. Among the GDM groups, group 4 had higher risks for pre-eclampsia, cesarean section, and LGA infant status than group 2.
Conclusion
Our data showed that obese women without GDM face higher risk of adverse pregnancy outcomes than women with supervised GDM and non-obese women. We also confirmed that adverse pregnancy outcomes associated with GDM were mainly attributable to obesity among women receiving GDM education.

Keyword

Gestational Diabetes; Obesity; Adverse Outcomes

Figure

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  Fig. 1 Flowchart of study participants.BMI = body mass index, GDM = gestational diabetic mellitus.

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