The condition of newborns from mothers with gestational diabetes mellitus and pregestational obesity

• Gayane A. Arakelyan
• Agamurad A. Orazmuradov
• Mayatskaya Tatyana A.
• Irina V. Bekbaeva
• Kotaysh Galina A.

Abstract

The increase in the number of women with gestational diabetes mellitus (GDM) is directly Linked to the obesity pandemic. However, their combined effect on the health of fetus has not been sufficiently studied.

The aim of the study was to study the effects of overweight and pregestational obesity in mothers with GDM on the health of their newborns.

Material and methods. A retrospective analysis of birth histories of 366 pregnant women with GSD and development maps of their newborns delivered in 2017-2020 in the Maternity Department of the City Clinical Hospital # 29 named after N.E. Bauman, at full-term pregnancy.

Results. In mothers with GDM on the background of overweight the health status of the newborn was the worst with increasing degrees of obesity compared to children of mothers normously: a) the Apgar score at the 1^st minute is 0.3 points, and at the 5^th minute - 0.4 points lower in newborns from obese women than from normal - weight ones; b) diabetic fetopathy in overweight and obese patients was 1.3 times more common compared to children from women with normal body weight, and 1.2-1.3 times more common compared to pregestational obesity.

Conclusion. As the degree of obesity increases, the risk of complications in newborns increases. It is necessary to stratify the risk and management tactics of overweight and obese pregnant women, starting from the early stages of pregnancy.

Keywords:gestational diabetes, obesity, metabolic syndrome, diagnosis, risk factors

References

1. Domanski G., Lange A.E., Ittermann T., Allenberg H., et al. Evaluation of neonatal and maternal morbidity in mothers with gestational diabetes: a population-based study. BMC Pregnancy Childb. 2018; 18 (1): 367. DOI: https://doi.org/org/10.1186/s12884-018-2005-9

2. Kautzky-Willer A., Harreiter J., Bancher-Todesca D., Berger A., et al. Gestational diabetes mellitus. Wien Klin Wochenschr. 2016; 128 (suppl 2): 103-12. DOI: https://doi.org/10.1007/s00508-015-0941-1

3. Reichelt A.J., Weinert L.S., Mastella L.S., Gnielka V., et al. Clinical characteristics of women with gestational diabetes - comparison of two cohorts enrolled 20 years apart in southern Brazil. Sao Paulo Med. 2017; 135 (4): 376-82. DOI: https://doi.org/10.1590/1516-3180.2016.0332190317

4. Papysheva O.V., Kotaysh G.A., Orazmuradov A.A., Arakelyan G.A., Savenkova I.V. Pregnancy complications in women with metabolic syndrome. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2018; 6 (3). Supplement: 1822. DOI: https://doi.org/10.24411/2303-9698-2018-13902 (in Russian)

5. Papysheva O.V., Kotaysh GA, Savenkova I.V., Arakelyan G.A., Lu-kanovskaya O.B., Damirova S.F. The influence of pregestational obesty to perinatal outcomes in women with gestation diabetes mellitus next? Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (3). Supplement: 25-30. DOI: https://doi.org/10.24411/2303-9698-2019-13903 (in Russian)

6. Prilepskaya V.N. The problem of obesity and women's health. Ginekologiya [Gynecology]. 2016; 4: 3-6. (in Russian)

7. Papysheva O.V., Kotaysh G.A., Lukanovskaya O.B., Arakelyan G.A., Savenkova I.V., Zhilinkova N.G., Volkova S.V. Is gestational diabetes mellitus another mask of metabolic syndrome? Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (3): 32-7. DOI: 10.24411/2303-9698-2019-13005 (in Russian)

8. Papysheva O., Kotaysh G., Mayatskaya T., Sidorova S., etc. Gestational diabetes mellitus in the conditions of the obesity pandemic: features of pathogenesis. Vrach [Doctor]. 2019; 30 (1): 27-32. DOI: https://doi.org/10.29296/25877305- 2019-01-04 (in Russian)

9. Gestational diabetes mellitus: diagnosis, treatment, postpartum follow-up. Clinical recommendations (protocol). M., 2014. 18 p. (approved by the Ministry of Health of the Russian Federation from 17.12.2013 no. 15-4/10/2-9478)

10. Vuong B., Odero G., Rozbacher S., Stevenson M. et al. Exposure to gestational diabetes mellitus induces neuroinfl ammation, derangement of hippocampal neurons, and cognitive changes in rat offspring // J. Neuroinfl amm. 2017. Vol. 14, N 1. P. 80. doi: 10.1186/s12974-017- 0859-9.

11. Nikitina I. L., Konoplya I. S., Polyanskaya A. A. and others. Characteristics of physical and psychomotor development of children born to mothers with gestational diabetes mellitus. 2017. No. 9. S. 14-20. DOI: https://doi.org/10.21518/2079-701X-2017-9-14-20

12. Pаpysheva O.V., Startsev N.M., Savenkova I.V., Arakelyan G.A., et al. Health of newborns from mothers with gestational diabetes mellitus: the current state of the problem. Doctor.ru. 2019; 7 (162): 12-8. DOI: https://doi.org/10.31550/1727-2378-2019-162-7-12-18

13. Babiyants A.Ya., Afonin A. A. Problems of perinatal damage of the central nervous system in children born to women with diabetes mellitus. Zhurnal fundamental'noy meditsiny i biologii [Journal of Fundamental Medicine and Biology]. 2017; 2: 28-37. (in Russian)

14. Litvinenko I.A. Effectiveness of predicting diabetic fetopathy in pregnant women with gestational diabetes mellitus. Autoabstract of Diss. Moscow, 2012. 19 p. (in Russian)

15. Riskin A., Garcia-Prats J.A., et al. Infants of women with diabetes. Literature review Jun 2019. URL: https://www.uptodate.com/contents/infants-of-women-with-diabetes

16. Daraki V., Roumeliotaki T., Koutra K., Georgiou V., Kampouri M., Kyriklaki A. et al. Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother-child cohort. Eur Child Adolesc Psychiatry. 2017; 26 (6): 703-14. DOI: https://doi.org/https://doi.org/10.1007/s00787-016-0934-2

17. Radzinsky V.E., Papysheva O.V., Esipova L.N., Startseva N.M., Kotaysh GA, Lukanovskaya O.B. Effectiveness of programmed delivery in gestational diabetes mellitus in reducing the frequency of cesarean section. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (3): 25-31. DOI: https://doi.org/10.24411/2303-9698- 2019-13004 (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)