The effect of maternal obesity on pregnancy outcomes of women with gestational diabetes controlled with diet only, glyburide, or insulin.
OBJECTIVE
To examine the effect of obesity on maternal and neonatal outcomes in women diagnosed with gestational diabetes mellitus (GDM) and managed with diet only, glyburide, or insulin.


METHODS
Women with singleton gestations enrolled for outpatient services diagnosed with GDM and without history of pregnancy-related hypertension at enrollment or in a prior pregnancy were identified in a database. Women with GDM controlled by diet only (n = 3918), glyburide (n = 873), or insulin without prior exposure to oral hypoglycemic agents (n = 2229) were included. Pregnancy outcomes were compared for obese versus nonobese women within each treatment group and also compared across treatment groups within the obese and nonobese populations.


RESULTS
Within each treatment group, obesity was associated with higher rates of cesarean delivery, pregnancy-related hypertension, macrosomia, and hyperbilirubinemia (all p < 0.05). Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in women receiving glyburide.


CONCLUSIONS
Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide.
Carolinas Medical Center, Charlotte, North Carolina 28203, USA. saju.joy@carolinashealthcare.org
Saju
S
Joy
Ashley
A
Roman
Niki
N
Istwan
Debbie
D
Rhea
Cheryl
C
Desch
Gary
G
Stanziano
Daniel
D
Saltzman
D015897:Comorbidity; D016640:Diabetes, Gestational / Q000178:diet therapy / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005905:Glyburide / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D016015:Logistic Models; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide