Gestationsdiabetes

2021 ◽  
Vol 19 (07) ◽  
pp. 312-316
Author(s):  
Delnaz Fard ◽  
Lars Brodowski ◽  
Constantin S. von Kaisenberg
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Body Mass ◽  
Gestational Age ◽  
Medikamentöse Therapie ◽  
Diabetes Mellitus Typ 2 ◽  
Large For Gestational Age ◽  
Kardiovaskuläre Ereignisse ◽  
Schwangerschaftsinduzierte Hypertonie

ZUSAMMENFASSUNGZiel: Review der Literatur zu Schwangeren mit Gestationsdiabetes, die ein erhöhtes peripartales Risiko aufweisen, welches im Rahmen des geburtshilflichen Managements Beachtung finden sollte.Methodik: Systematische Literaturrecherche.Ergebnisse: Als Gestationsdiabetes wird ein erstmals in der Schwangerschaft auftretender bzw. diagnostizierter Diabetes bezeichnet. Die Pathophysiologie und das Risikoprofil entsprechen dem des Diabetes mellitus Typ 2. Eine entscheidende Rolle spielen dabei, neben einer genetischen Disposition, der mütterliche Body-Mass-Index, der Lebensstil sowie frühere Schwangerschaften mit Gestationsdiabetes. Die Diagnosestellung erfolgt durch einen 75 g oralen Glukosetoleranztest, meist bei 24–28 Schwangerschaftswochen. Die Folgen für die Mutter sind vor allem die schwangerschaftsinduzierte Hypertonie und Präeklampsie sowie im Verlauf die erhöhte Inzidenz für kardiovaskuläre Ereignisse. Intrapartal zeigen sich zudem eine erhöhte Sectio-Rate bei fetalem Large for gestational age und ein erhöhtes Risiko für höhergradige Geburtsverletzungen und atone Nachblutungen. Die Therapie schließt sowohl die Lifestyle-Modifikation als auch die medikamentöse Therapie mit Insulin ein.Schlussfolgerungen: Durch die frühzeitige Diagnosestellung durch adäquate Testverfahren und konsequent eingeleitete Therapien kann das peripartale maternale und fetale Risiko reduziert werden.

scholarly journals Maternal Body Mass Index and Ethnicity in Relation to The Adverse Outcomes of Large for Gestational Age and Gestational Diabetes Mellitus in a Retrospective Cohort of Australian Pregnant Women.

2021 ◽  
Author(s):  
Catherine Knight-Agarwal ◽  
Jani Rati ◽  
Meisa Al-Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Body Mass Index

Abstract Background: The prevalence of maternal overweight and obesity has been increasing. This research explored the association between maternal body mass index and ethnicity in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus. Method: A retrospective cohort study was undertaken with 27 814 Australian women of various ethnicities, who gave birth to a singleton infant between 2008 and 2017. Variables were examined using logistic regression. Results: A significantly higher proportion of large for gestational age infants were born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women with a body mass index of ≥ 40kg/m2 had an adjusted odds ratio of 9.926 (3.859 - 25.535) for birthing a large for gestational age infant whereas Australian-born women had an adjusted odds ratio of 2.661 (2.256 - 3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin controlled gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational infant, in either the diet controlled, or insulin controlled gestational diabetes mellitus groups. Conclusion: Large for gestational age and gestational diabetes mellitus are adverse pregnancy outcomes that can lead to significant maternal and neonatal morbidity. Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period.

scholarly journals Maternal body mass index and country of birth in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus in a retrospective cohort of Australian pregnant women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine R. Knight-Agarwal ◽  
Rati Jani ◽  
Meisa Al Foraih ◽  
Dionne Eckley ◽  
Carrie Ka Wai Lui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Body Mass Index ◽  
Country Of Birth

Abstract Background The prevalence of gestational diabetes mellitus in Australia has been rising in line with the increased incidence of maternal overweight and obesity. Women with gestational diabetes mellitus, high body mass index or both are at an elevated risk of birthing a large for gestational age infant. The aim was to explore the relationship between country of birth, maternal body mass index with large for gestational age, and gestational diabetes mellitus. In addition to provide additional information for clinicians when making a risk assessment for large for gestational age babies. Method A retrospective cohort study of 27,814 women residing in Australia but born in other countries, who gave birth to a singleton infant between 2008 and 2017 was undertaken. Logistic regression analysis was used to examine the association between the aforementioned variables. Results A significantly higher proportion of large for gestational age infants was born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women residing in Australia, with a body mass index of ≥40 kg/m2, had an adjusted odds ratio of 9.926 (3.859–25.535) for birthing a large for gestational age infant. Conversely, Australian-born women with a body mass index of ≥40 kg/m2 had an adjusted odds ratio of 2.661 (2.256–3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin-requiring gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational age infant, in either the diet controlled, or insulin requiring gestational diabetes mellitus groups. Conclusions Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period to reduce their risk of adverse outcomes.

Rolle der metabolischen Chirurgie bei Diabetes mellitus Typ 2 und NASH

2010 ◽  
Vol 04 (02) ◽  
pp. 79-83
Author(s):  
F. X. Felberbauer ◽  
A. Bohdjalian ◽  
F. Langer ◽  
S. Shakeri-Leidenmühler ◽  
B. Ludvik ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Body Mass ◽  
Bariatrische Chirurgie ◽  
Diabetes Mellitus Typ 2 ◽  
Metabolische Chirurgie ◽  
Nichtalkoholische Steatohepatitis

Zusammenfassung Diabetes mellitus Typ 2 stellt bereits heute in ökonomischer, medizinischer und sozialer Hinsicht ein globales Problem dar, dessen Bedeutung in den nächsten zwei Jahrzehnten noch massiv zunehmen wird. Bariatrische Chirurgie ist zweifelsohne die wirkungsvollste Behandlung von morbider Adipositas, führt zu substantiellem, anhaltendem Gewichtsverlust, Verbesserung von Begleiterkrankungen und Reduktion von Mortalität. Metabolische Chirurgie führt bei 56 bis 95 % der morbid adipösen Typ-2-Diabetiker zur Diabetesremission. Jüngste Ergebnisse zeigen für Patienten mit einem Body-Mass-Index zwischen 30 und 40 kg/m2 ebenfalls exzellente Ergebnisse. Die Verbesserung der diabetischen Stoffwechsellage ist auch auf eine kalorische Restriktion und Änderung der gastrointestinalen Hormonsekretion zurückzuführen. Die Etablierung von Diabeteschirurgie verlangt ein besseres pathophysiologisches Verständnis der Erkrankung und der Operationsmethoden – diese Arbeit beschreibt den Einfluss etablierter Operationsmethoden auf die diabetische Stoffwechsellage und die Hormonsekretion des Gastrointestinaltrakts. NASH (nichtalkoholische Steatohepatitis) betrifft rund ein Drittel der morbid adipösen Patienten. Es werden Prävalenz, Diagnosestellung und Beeinflussung der Erkrankung durch metabolische Chirurgie diskutiert. Der Goldstandard zur Diagnosestellung ist nach wie vor die Leberbiopsie. In mehreren Publikationen konnte die positive Beeinflussung der NASH durch metabolische Chirurgie gezeigt werden – für morbid adipöse Patienten stellt metabolische Chirurgie die effektivste Therapie der NASH dar.

scholarly journals Screening of gestational diabetes mellitus using fasting plasma glucose before the 24th gestational week in women with different pre-pregnancy body mass index

2020 ◽  
Vol 7 (2) ◽  
pp. 218
Author(s):  
Sambit Das ◽  
Mahesh Rath ◽  
Lipsa Das ◽  
Kasturi Bharadwaj
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Overweight And Obesity ◽  
Oral Glucose ◽  
Gestational Week ◽  
Overweight Or Obesity

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ≥92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ≥92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.

Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth

2007 ◽  
Vol 196 (6) ◽  
pp. 530.e1-530.e8 ◽  
Author(s):  
Darios Getahun ◽  
Cande V. Ananth ◽  
Morgan R. Peltier ◽  
Hamisu M. Salihu ◽  
William E. Scorza
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Prepregnancy Body Mass Index

Growth factors, adiponectin, leptin and body mass index in pre-pubertal children born large for gestational age

2010 ◽  
Vol 34 (6) ◽  
pp. 411-416 ◽  
Author(s):  
A. S. Challa ◽  
E. N. Evagelidou ◽  
V. I. Giapros ◽  
V. I. Cholevas ◽  
S. K. Andronikou
Keyword(s):  
Body Mass Index ◽  
Growth Factors ◽  
Body Mass ◽  
Gestational Age ◽  
Large For Gestational Age

scholarly journals Estimating bias in derived body mass index in the Maternity Experiences Survey

2016 ◽  
Vol 36 (9) ◽  
pp. 185-193 ◽  
Author(s):  
S. Dzakpasu ◽  
J. Duggan ◽  
J. Fahey ◽  
R. S. Kirby
Keyword(s):  
Body Mass Index ◽  
Caesarean Section ◽  
Random Sample ◽  
Body Mass ◽  
Gestational Age ◽  
Measured Data ◽  
The Body ◽  
Large For Gestational Age ◽  
Maternity Experiences Survey ◽  
The Impact

Introduction The objective of this study was to assess bias in the body mass index (BMI) measure in the Canadian Maternity Experiences Survey (MES) and possible implications of bias on the relationship between BMI and selected pregnancy outcomes. Methods We assessed BMI classification based on self-reported versus measured values. We used a random sample of 6175 women from the MES, which derived BMI from self-reported height and weight, and a random sample of 259 women who had previously given birth from the Canadian Health Measures Survey (CHMS), which derived BMI from self-reported and measured height and weight. Two correction equations were applied to self-reported based BMI, and the impact of these corrections on associations between BMI and caesarean section, small-for-gestational age (SGA) and large-for-gestational age (LGA) births was studied. Results Overall, 86.9% of the CHMS subsample was classified into the same BMI category based on self-reported versus measured data. However, misclassification had a substantial effect on the proportion of women in underweight and obese BMI categories. For example, 14.5% versus 20.8% of women were classified as obese based on self-reported data versus measured data. Corrections improved estimates of obesity prevalence, but over- and underestimated other BMI categories. Corrections had nonsignificant effects on the associations between BMI and SGA, LGA, and caesarean section. Conclusion While there was high concordance in BMI classification based on selfreported versus measured height and weight, bias in self-reported based measures may slightly over- or underestimate the risks associated with a particular BMI class. However, the general trend in associations is unaffected.

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