Clinical features of patients with gestational diabetes mellitus in combination with obesity and preeclampsia
AbstractThe aim of the study was to determine whether gestational diabetes mellitus (GDM) with or without preeclampsia is associated with comorbidities, delivery complications during childbirth, adverse perinatal outcomes in patients with and without fat metabolism disorders and high BMI.
Material and methods. The association between GDM with or without preeclampsia was analyzed in a population of 204 pregnant women with or without fat metabolism disorders and high BMI. All patients were aged 21 to 46 years, of which 134 were diagnosed with GDM during the current pregnancy and 70 with GDM in combination with PE. One of the most important risk factors for all groups was obesity, both groups were divided into 2 subgroups depending on presence or absence of BMI.
Results. Pregnant women with GDM were statistically significantly (p<0.05) more likely to have a history of acute bronchitis, medical abortion in three pregnancies, four and five births in anamnesis, and mild anemia in the current pregnancy. Pregnant women with GDM and obesity were statistically significantly (p<0.05) more likely to have: normal type of menstrual function, multiple births in anamnesis. Pregnant women with GDM and PE, statistically significantly (p<0.05) more often were detected: PE in two previous pregnancies, hemorrhage in early postpartum period. In pregnant women with GDM and PE in combination with obesity, the following were statistically significantly (p<0.05) more often detected: chronic arterial hypertension, disorders of the vaginal microbiocenosis, fetal distress as an indication for surgical delivery in history.
Conclusion. There is a significant association between GDM + PE and obesity. Obesity is associated with poor prognosis and more severe pregnancy outcomes. Obesity is a major confounding factor contributing to higher risk of obstetric complications and adverse infant outcomes.
Keywords:pregnancy; pregnant women with impaired fat metabolism; obesity; gestational diabetes mellitus; preeclampsia; elevated body mass index; complicated pregnancy; perinatal risk
Funding. The study had no sponsor support.
Conflict of interest. The author declares no conflict of interest.
For citation: Grabovskiy V.M. Clinical features of patients with gestational diabetes mellitus in combination with obesity and preeclampsia. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2023; 11. Supplement: 67–73. DOI: https://doi.org/10.33029/2303-9698-2023-11-suppl-67-73 (in Russian)
REFERENCES
1. World Health Organization Classification on of Diabetes Mellitus. Geneva, 2019.
2. Lowe L.P., Metzger B.E., Dyer A.R., Coustan D.R., Hadden D.R., Hod. M., et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: an overview. In: C. Kim, A. Ferrara (eds). Gestational Diabetes during and after Pregnancy. London: Springer; 2010: 17–34.
3. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization guideline. Diabetes Res Clin Pract. 2014; 103 (3): 341–63.
4. Ostlund I., Haglund B., Hanson U. Gestational diabetes and preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2004; 113 (1): 12–6. DOI: https://doi.org/10.1016/j.ejogrb.2003.07.001 PMID: 15036703.
5. McMahon M.J., Ananth C.V., Liston R.M. Gestational diabetes mellitus. Risk factors, obstetric complications and infant outcomes. J Reprod Med. 1998; 43 (4): 372–8. PMID: 9583071.
6. Rao R., Sen S., Han B., Ramadoss S., Chaudhuri G. Gestational diabetes, preeclampsia and cytokine release: similarities and differences in endothelial cell function. Adv Exp Med Biol. 2014; 814: 69–75. DOI: https://doi.org/10.1007/978-1-4939-1031-1_6
7. Getahun D., Ananth C.V., Oyelese Y., Chavez M.R., Kirby R.S., Smulian J.C. Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies. Obstet Gynecol. 2007; 110 (6): 1319–25. DOI: https://doi.org/10.1097/01.AOG.0000292090.40351.30 PMID: 18055727.
8. Yang Y., Wu N. Gestational diabetes mellitus and preeclampsia: Correlation and influencing factors. Front Cardiovasc Med. 2022; 9: 831297. DOI: https://doi.org/10.3389/fcvm.2022.831297 PMID: 35252402; PMCID: PMC8889031.
9. Dodkhoeva M.F., Pirmatova D.A. Gestational diabetes mellitus: a modern view on the actual problem. Vestnik Avitsenny [Avicenna Bulletin]. 2018; 20 (4): 455–61. URL: http://dx.doi.org/10.25005/2074-0581-2018-20-4-455-461