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Cited by 42Gestational Diabetes Research and ManagementBirth, Development, and HealthMaternal and Neonatal Healthcare

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: A population based cohort study in Sweden

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Hildén, K., Hanson, U., Persson, M., Magnuson, A., Simmons, D., Fadl, H.·2019·Diabetic Medicine
DOI 10.1111/dme.13843PMC PMC6590111
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Abstract

Aims: To evaluate the interaction effects of gestational diabetes (GDM) with obesity on perinatal outcomes. Methods: A population‐based cohort study in Sweden excluding women without pre‐gestational diabetes with a singleton birth between 1998 and 2012. Logistic regression was performed to evaluate the potential independent associations of GDM and BMI with adverse perinatal outcomes as well as their interactions. Main outcome measures were malformations, stillbirths, perinatal mortality, low Apgar score, fetal distress, prematurity and Erb's palsy. Results: Some 1,294,006 women were included, with a GDM prevalence of 1% (n = 14,833). The rate of overweight/obesity was 67.7% in the GDM‐group and 36.1% in the non‐GDM‐group. No significant interaction existed. Offspring of women with GDM had significantly increased risk of malformations, adjusted odds ratio (aOR) 1.16 (95% confidence intervals 1.06–1.26), prematurity, aOR 1.86 (1.76–1. 98), low Apgar score, aOR 1.36 (1.10–1.70), fetal distress, aOR 1.09 (1.02–1.16) and Erb's palsy aOR 2.26 (1.79–2.86). No risk for stillbirth or perinatal mortality was seen. Offspring of overweight (BMI 25–29.9 kg/m 2), obese (BMI 30–34.9 kg/m 2) and severely obese women (BMI ≥ 35.0 kg/m 2) had significantly increased risks of all outcomes including stillbirth 1.51 (1.40–1.62) to 2.85 (2.52–3.22) and perinatal mortality 1.49 (1.40–1.59) to 2.83 (2.54–3.15). Conclusions: There is no interaction effect between GDM and BMI for the studied outcomes. Higher BMI and GDM are major independent risk factors for most serious adverse perinatal outcomes. More effective pre‐pregnancy and antenatal interventions are required to prevent serious adverse pregnancy outcomes among women with either GDM or high BMI.

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Authors
Hildén, K., Hanson, U., Persson, M., Magnuson, A., Simmons, D., & Fadl, H.
Affiliations
  • Örebro University (SE)
  • Uppsala University (SE)
  • Karolinska University Hospital (SE)
Corresponding author
Hildén, K.
ORCID
Venue
Diabetic Medicine
Publisher
Wiley
Published
2019-01-30
Volume
36
Issue
2
Pages
151-157
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
DOI
10.1111/dme.13843
PMC
PMC6590111
OpenAlex
W2913305891
Cited by
42
References
3
Citations by year
2026: 4 · 2025: 2 · 2024: 2 · 2023: 10 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 3
FWCI
6.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetic Medicine (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
gestational diabetes mellitus, maternal obesity, body mass index, perinatal outcomes, adverse pregnancy outcomes, congenital malformations, stillbirth, perinatal mortality, preterm birth, low Apgar score, fetal distress, Erb's palsy, pre-pregnancy weight, risk factors, interaction effects, singleton pregnancy, antenatal interventions, Sweden, population-based cohort
MeSH terms
Congenital Abnormalities, Adult, Female, Fetal Death, Humans, Maternal Age, Obesity, Pregnancy, Pregnancy Outcome, Prospective Studies, Registries, Risk Factors, Sweden, Body Mass Index, Diabetes, Gestational, Adiposity, Overweight, Stillbirth

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