Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia.
OBJECTIVE
We evaluated diabetes-related pregnancy outcomes in a cohort of Spanish women in relation to their glucose tolerance status, prepregnancy BMI and other predictive variables.


METHODS
The present paper is part of a prospective study to evaluate the impact of American Diabetes Association (2000) criteria in the Spanish population. A total of 9,270 pregnant women were studied and categorised as follows according to prepregnancy BMI quartiles and glucose tolerance status: (1) negative screenees; (2) false-positive screenees; (3) gestational diabetes mellitus (GDM) according to American Diabetes Association criteria only; and (4) GDM according to National Diabetes Data Group criteria (NDDG). We evaluated fetal macrosomia, Caesarean section and seven secondary outcomes as diabetes-related pregnancy outcomes. The population-attributable and population-prevented fractions of predictor variables were calculated after binary logistic regression analysis with multiple predictors.


RESULTS
Both prepregnancy BMI and abnormal glucose tolerance categories were independent predictors of pregnancy outcomes. The upper quartile of BMI accounted for 23% of macrosomia, 9.4% of Caesarean section, 50% of pregnancy-induced hypertension and 17.6% of large-for-gestational-age newborns. In contrast, NDDG GDM accounted for 3.8% of macrosomia, 9.1% of pregnancy-induced hypertension and 3.4% of preterm births.


CONCLUSIONS
In terms of population impact, prepregnancy maternal BMI exhibits a much stronger influence than abnormal blood glucose tolerance on macrosomia, Caesarean section, pregnancy-induced hypertension and large-for-gestational-age newborns.
Ricart
W
W
Unit of Diabetes, Endocrinology and Nutrition, University Hospital Doctor Josep Trueta, Avgda. de frança s.n., 17007, Girona, Spain. uden.wricart@htrueta.scs.es
López
J
J
Mozas
J
J
Pericot
A
A
Sancho
M A
MA
González
N
N
Balsells
M
M
Luna
R
R
Cortázar
A
A
Navarro
P
P
Ramírez
O
O
Flández
B
B
Pallardo
L F
LF
Hernández-Mijas
A
A
Ampudia
J
J
Fernández-Real
J M
JM
Corcoy
R
R
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D013030:Spain
D001786:Blood Glucose