title: Prepregnancy Weight in Women with Type I Diabetes Mellitus: Effect on Pregnancy Outcomes.
abstract: ObjectiveThis study aims to evaluate the association between prepregnancy body mass index (BMI) and adverse pregnancy outcomes in women with type 1 diabetes mellitus (DM).MethodsThis is a secondary analysis of a cohort of 426 pregnancies in women with type 1 DM recruited before 20 weeks gestation. Women were categorized according to prepregnancy BMI: low BMI (< 20 kg/m2), normal BMI (20 to < 25 kg/m2), and high BMI (≥ 25 kg/m2). The outcomes of interest were: spontaneous abortion (delivery < 20 weeks gestation); preeclampsia; emergent delivery for maternal indications (hypertension or placental abruption); and preterm delivery (< 37 weeks gestation). Analyses included proportional hazards and multiple logistic regression models with covariates: age, age at diagnosis of type 1 DM, previous spontaneous abortion, microvascular disease (nephropathy or retinopathy), and glycohemoglobin A1concentrations.ResultsLow BMI was associated with preterm delivery. High BMI was associated with emergent delivery for maternal indications. Glycemic control as measured by glycohemoglobin A1was associated with increased risk of spontaneous abortion, attenuating the association with low prepregnancy weight.ConclusionPrepregnancy BMI is a risk factor to be considered when caring for women with type 1 DM, in particular for preterm delivery (low BMI) and emergent delivery for maternal indications (high BMI).
authors.affiliation: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: T
authors.initials: T
authors.lastname: Kawakita
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: K
authors.initials: K
authors.lastname: Bowers
authors.affiliation: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: E
authors.initials: E
authors.lastname: Coviello
authors.affiliation: Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, Maryland.
authors.forename: M
authors.initials: M
authors.lastname: Miodovnik
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: S
authors.initials: S
authors.lastname: Ehrlich
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai West Hospital, New York, New York.
authors.forename: B
authors.initials: B
authors.lastname: Rosenn
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: J C
authors.initials: JC
authors.lastname: Khoury
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000037:Abruptio Placentae / Q000628:therapy; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human