CC BY-NC-ND 4.0 · AJP Rep 2017; 07(02): e128-e133
DOI: 10.1055/s-0037-1603913
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diabetes during Pregnancy: Influence of Body Mass Index on Composite Morbidity

Amy E. O'Neil Dudley
1  Department of Family Medicine, Texas A&M College of Medicine, Bryan, Texas
,
Zachary B. Jenner
2  Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School–The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
,
Hector Mendez-Figueroa
3  Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School–The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
,
Viviana S. Ellis
4  Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
,
Suneet P. Chauhan
3  Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School–The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
› Author Affiliations
Further Information

Publication History

19 December 2016

26 April 2017

Publication Date:
30 June 2017 (online)

  

Abstract

Objective This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m2 (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes.

Methods This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death. NM was defined as umbilical arterial pH < 7.0, 5 minute Apgar < 4, respiratory distress syndrome, mechanical ventilation, neonatal sepsis, stillbirth, and/or death. Odds ratios were adjusted for possible confounders.

Results MM was noted in 8, 13, and 24% of groups 1, 2, and 3, respectively, and significantly more common in group 2 versus 1 (adjusted odds ratio [aOR]: 1.66) and group 3 versus 1 (aOR: 3.06). NM was noted in 7, 8, and 15% of each BMI group, respectively, and differed significantly between group 3 vs. 2 (aOR: 1.77).

Conclusions The increased rate of morbidities between the BMI groups is useful to inform diabetic women and highlights the need for further investigation of diabetes and obesity as comorbidities in pregnancy.

Note

This article was presented at the 2016 Annual Meeting of the Central Association of Obstetricians & Gynecologists; October 27, 2016; Las Vegas, NV.