title: The effect of gestational diabetes, pre-gravid maternal obesity, and their combination ('diabesity') on outcomes of singleton gestations.
abstract: OBJECTIVE
  To assess the effect of the combination of gestational diabetes mellitus (GDM) and pre-gravid obesity ('diabesity') in singleton gestations.
  
  
  METHODS
  We compared perinatal outcomes of singleton gestations in mothers with GDM and pre-gravid obesity, with GDM but with normal pre-gravid BMI, and obese mothers without GDM.
  
  
  RESULTS
  We compared diabesity mothers (n = 1525, 24.4% of mothers with GDM, 9.9% of all obese women) to mothers with GDM but with normal BMI (n = 4704, 75.6% of mothers with GDM) and to obese mothers without GDM (n = 13,937, 90.1% of all obese mothers). Obesity, with and without GDM, increased the odds of having chronic hypertension whereas preeclampsia appears to be influenced by obesity only, as were the risk of births at <33 weeks' gestation, of birth weight >4000 g, low 5-min Apgar scores and NICU admissions.
  
  
  CONCLUSIONS
  Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM.
authors.affiliation: a Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel.|b Hadassah-Hebrew University School of Medicine , Jerusalem , Israel.
authors.forename: Isaac
authors.initials: I
authors.lastname: Blickstein
authors.affiliation: b Hadassah-Hebrew University School of Medicine , Jerusalem , Israel.
authors.forename: Reut
authors.initials: R
authors.lastname: Doyev
authors.affiliation: c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia.
authors.forename: Andreja
authors.initials: A
authors.lastname: Trojner Bregar
authors.affiliation: c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia.
authors.forename: Gabrijela
authors.initials: G
authors.lastname: Bržan Šimenc
authors.affiliation: c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Verdenik
authors.affiliation: c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Tul
mesh_terms: D000328:Adult; D001034:Apgar Score; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Obesity; diabesity; gestational diabetes; pregnancy outcome